Predictive Value of Magnetic Resonance Imaging in Cervical Spondylotic Myelopathy in Prognostic Surgical Outcome
Pipat Chiewvit MD*, Siri-on Tritrakarn MD*, Anchalee Phawjinda MD*, Areesak Chotivichit MD**
Affiliation : * Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Department of Orthopedics Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : Establish the predictive value of magnetic resonance imaging (MRI) for cervical spondylotic myelopathy as being
a good operative outcome.
Material and Method: A retrospective study of the 52 consecutive patients with cervical spondylotic myelopathy underwent
both magnetic resonance imaging (MRI) cervical spines examination at Siriraj Hospital between January 2005 and June
2007. Surgery was divided into two groups: “Good” operative outcome (35 patients) and “No improvement group” (17
patients). Two neuroradiologists independently identified the MR images data that showed the maximum stenosis on sagittal
and axial sections and recorded predictive MRI parameters: T2-weighted signal change of the spinal cord, cross-sectional
area of the spinal cord, anteroposterior (AP) diameter of the spinal canal and the spinal cord and AP-compression ratio (AP
diameter/transverse diameter of the spinal cord).
Results : There were no statistically significant differences between both groups in all parameters.
Conclusion : The AP-diameter of the spinal canal and spinal cord, AP-compression ratio and signal change of the spinal cord
are not useful in predicting prognosis outcome in patients with cervical spondylotic myelopathy. In addition, cross-sectional
area of the spinal cord cannot confidentially be used as predictive factor in CSM patients due to many influent factors of
surgical outcome. A further prospective study without patient selective bias may offer more definite results to confirm these
findings.
Keywords : Magnetic resonance imaging, Cervical spondylotic myelopathy, Predictive outcome
