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Diagnosis and treatment of hidden lesions in "mild" cervical spondylotic myelopathy patients with apparent symptoms.

Abstract Patients with apparent symptoms of cervical spondylotic myelopathy (CSM) may only show a mild compressive lesion in ordinary magnetic resonance imaging (MRI). The aim of this study was to investigate the characteristics of CSM patients with "hidden" lesions on kinetic MRI and to determine an effective treatment.Thirty-one patients with obvious spinal cord compression only on kinetic MRI were included in our study. A variety of parameters were calculated from MRI of the cervical spine at different postures. The anterior cervical decompression and fusion (ACDF) procedure were used for treatment of CSM. To evaluate the effect of surgery, a further 31 age- and gender-matched ordinary CSM patients that received ACDF procedures were enrolled as the control group.The diameter of the cervical cord at the narrowest level in extension was significantly lower than that in the neutral posture (P < .01). The percentage of spinal cord compression was 34.6%. The diameter of the cervical canal at the narrowest level in the extension posture was significantly lower than that in the neutral posture (P < .01). The percentage of cervical canal stenosis was 43.6%. The anteroposterior diameter of the cervical canal in the case group was significantly lower than that in the control group (P < .01). However, the recovery rate of the Japanese Orthopaedic Association score at final follow-up was comparable between the case group and the control group (P = .53).Kinetic MRI is useful for the diagnosis of CSM with hidden lesions. ACDF is an effective procedure for treatment of CSM.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28746221
OWN - NLM
STAT- In-Process
DA  - 20170726
LR  - 20170726
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 30
DP  - 2017 Jul
TI  - Diagnosis and treatment of hidden lesions in "mild" cervical spondylotic
      myelopathy patients with apparent symptoms.
PG  - e7623
LID - 10.1097/MD.0000000000007623 [doi]
AB  - Patients with apparent symptoms of cervical spondylotic myelopathy (CSM) may only
      show a mild compressive lesion in ordinary magnetic resonance imaging (MRI). The 
      aim of this study was to investigate the characteristics of CSM patients with
      "hidden" lesions on kinetic MRI and to determine an effective
      treatment.Thirty-one patients with obvious spinal cord compression only on
      kinetic MRI were included in our study. A variety of parameters were calculated
      from MRI of the cervical spine at different postures. The anterior cervical
      decompression and fusion (ACDF) procedure were used for treatment of CSM. To
      evaluate the effect of surgery, a further 31 age- and gender-matched ordinary CSM
      patients that received ACDF procedures were enrolled as the control group.The
      diameter of the cervical cord at the narrowest level in extension was
      significantly lower than that in the neutral posture (P &lt; .01). The percentage of
      spinal cord compression was 34.6%. The diameter of the cervical canal at the
      narrowest level in the extension posture was significantly lower than that in the
      neutral posture (P &lt; .01). The percentage of cervical canal stenosis was 43.6%.
      The anteroposterior diameter of the cervical canal in the case group was
      significantly lower than that in the control group (P &lt; .01). However, the
      recovery rate of the Japanese Orthopaedic Association score at final follow-up
      was comparable between the case group and the control group (P = .53).Kinetic MRI
      is useful for the diagnosis of CSM with hidden lesions. ACDF is an effective
      procedure for treatment of CSM.
FAU - Sun, Yaning
AU  - Sun Y
AD  - Department of Orthopedics, The Third Hospital of Hebei Medical University,
      Shijiazhuang, Hebei, P.R. China.
FAU - Yu, Kunlun
AU  - Yu K
FAU - Wang, Haonan
AU  - Wang H
FAU - Shen, Yong
AU  - Shen Y
FAU - Kong, Lingde
AU  - Kong L
FAU - Zhang, Jingtao
AU  - Zhang J
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
EDAT- 2017/07/27 06:00
MHDA- 2017/07/27 06:00
CRDT- 2017/07/27 06:00
AID - 10.1097/MD.0000000000007623 [doi]
AID - 00005792-201707280-00052 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jul;96(30):e7623. doi: 10.1097/MD.0000000000007623.