Research On The Risk Factors Of Cervical Spondylotic Myelopathy With Intramedullary High Signals On MRI T2WI Change Pre- And Post-operation And The Prognosis

Objective To study the risk factors of cervical spondylotic myelopathy with intramedullary high signals on Magnetic resonance imaging(MRI) T2-weighted images(T2WI) change pre- and post- operation and the prognosis.Methods Retrospectively studied 74 patients who had underwent cervical spine surgery of cervical spondylotic myelopathy with iso-intensity signal in T1-weighted images(T1WI) and high-intensity signal in T2-weighted images(T2WI) in department of spine surgery of our hospital. Pre- and post-operative image and clinical data were collected from August 2012 to March 2014. After evaluation of spinal intramedullary high signal intensity(ISI) and its change during follow-up after surgery, we divided individuals into three groups: Intensity decrease group(29 cases), no change group(32 cases), and intensity increase group(13 cases). And measured most serious segmental spinal cord compression ratio(CR) and m JOA score(the modified Japanese Orthopaedic Association score, m JOA) were calculated and recorded for each group. Three groups of patients with gender, age, course of the disease, preoperative and postoperative pathological changes of segmental spinal cord compression rate, high preoperative T2 WI signal segment, preoperative cervical three-dimensional CT(Three- Dimensional Computed Tomography) on the compression of the spinal cord tissue types, preoperative and postoperative m JOA score, Clinical recovery rate(RR) were compared by statistical methods. Analysis of patients with the spinal intramedullary MRI T2WIhigh signal intensity postoperative change of related affecting factors and the correlation of high signal change and clinical prognosis.Results There were no statistically significant difference among the three groups in gender, preoperative spinal signal scale, preoperative spinal cord compression rate, postoperative spinal cord compression rate and preoperative JOA score comparison. There was a significant difference in age, course of the disease, high signal segment number, compression of the spinal cord tissue types, postoperative JOA score and clinical recovery rate between decrease group and the other two groups. There were no statistical relation of the preoperative spinal signal scale and spinal cord compression rate, m JOA scores, clinical period.Conclusion For patients who had cervical spondylotic myelopathy with iso-intensity signal in T1 WI and high-intensity signal in T2 WI, preoperative T2 WI signal intensity change is not a predictive value for clinical prognosis. MRI T2 WI signal intensity weakening indicate better prognosis after surgery. Patients with younger age, shorter duration, single high signal segment and osseous compression are more likely to have a decrease signal intensity in T2 WI after surgery.