Category: Spinal Cord Injury; Neuroplasticity (includes neuroscience); Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
To delineate the usefulness and limitations of preoperative diffusion tensor imaging and tractography by comparing images after spine surgery and long-term follow up.
Randomized controlled study
Department of rehabilitation medicine in the university hospital
Participants (or Animals, Specimens, Cadavers) :
40 patients with cervical cord injury
Forty cervical spinal cord injury (SCI) patients were performed diffusion tensor imaging (DTI) preoperatively, and 16 cervical SCI patients received DTI after spine surgery. Twenty-two age-matched subjects who had no SCI served as controls.
Main Outcome Measure(s) :
Fractional anisotropy (FA), apparent diffusion coefficient (ADC), and imaginary fiber numbers at each cervical level from C3 to C7, and crossing fiber numbers from C3 to C5, C6 or C7 were calculated.
Preoperative FA and fiber numbers were lower in SCI patients than in the control group. However, fiber numbers were much higher, especially at C6 and C7 levels, compared with those in SCI patients after surgery. Fiber numbers crossing cervical lesion were increased in proportion to the functional improvement during 4-week follow up after surgery, and this increase was significant when compared with postoperative findings, not preoperative values.
Preoperative DTI and FT seem to reflect clinical status of cervical SCI patients better than postoperative ones, but postoperative and follow-up tests might be useful to match clinical improvement of cervical SCI patients.