CLINICAL-VALUE OF MAGNETIC-RESONANCE-IMAGING FOR CERVICAL MYELOPATHY

The magnetic resonance imaging (MRI) findings in 115 cases of cervical myelopathy, 121 cases of cervical radic-ulopathy, and 64 cases of neck pain with no neurologic deficit were prospectively studied to investigate the clin-ical value of MRI for cervical myelopathy. The MRI findings in the T1-weighted sagittal projection were classified into four groups according to the degree of the compressed deformities of the cervical cord. The degree of compression of the cervical cord on MRI findings showed a significant correlation with the severity of myelopathy, the anteroposterior diameter of the spinal column, and the degree of compression of the dural tube in the myel-ograms (P < 0.01). Fifty-one patients of cervical myelop-athy had undergone both preoperative and postoperative MRI. Of these, the spinal canal of 47 patients that was well decompressed was recognized according to plain com-puted tomography (CT). However, 24 (51%) of these 47 patients showed on MRI a deformity in the spinal cord amounting to cord atrophy. The correlation between the clinical function of the spinal cord and the recovery of the cord deformity on MRI at the operative levels was accu-rately investigated in 34 patients who had no cord defor-mities in the adjacent intervertebral levels. Twenty patients with cord atrophy had sligtly poor clinical results, although no significant difference was found between these 20 and 14 patients with recovery in the cord defor-mities. From these results, it was evident that T1- weighted MRI is useful in the accurate diagnosis of compression myelopathy, in accurately deciding the level of the disease focus, and in the accurate assessment of the surgical results. © Lippincott-Raven Publishers.