Radiographic parameters, demographic characteristics of patients, and surgical outcomes characterized based on the Japanese Orthopedic Association (JOA) score were compared between these two groups.įor further analysis, we divided the patients in the non-SCECS group into three subgroups comprising those negative for ISI on MRI, those positive for ISI only on T2WI, and those positive for ISI on both T1-weighted MR images (T1WI) and T2WI. We divided the patients into two groups, SCECS group and non-SCECS group. The selection of the surgeon, patients, and operative methods was not randomized. Patients with disc hernia, ossification of the longitudinal ligament, tumors, rheumatoid arthritis, or a history of trauma and spine surgery were excluded. This retrospective cohort study included 214 patients with cervical spondylotic myelopathy who underwent surgery between April 2007 and March 2017 at our institution. The purpose of this study was to investigate the clinical characteristics of spinal cord edema due to cervical spondylosis (SCECS). However, intramedullary hyperintense lesions with spinal cord edema are not well characterized in the literature. Such edematous lesions are liable to be misinterpreted as neoplastic or inflammatory lesions in the spinal canal, and this can delay appropriate treatment. speculated that the radiological characterization of spinal cord edema was based on reversible white matter lesions, which were most likely caused by disturbed local venous circulation. In a report of six patients with cervical spinal cord edema, Lee et al. Intramedullary hyperintense lesions associated with spinal cord edema on T2WI are rare findings in patients with cervical spondylosis. suggested that the snake-eye appearance was a result of cystic necrosis resulting from mechanical compression and venous infarction. described myelomalacia as a radiographical finding on MRI manifested by an ill-defined area of cord signal change visible on T1- and T2-weighted sequences as hypo- and hyperintense areas and commonly associated with focal cord atrophy. Most intramedullary lesions in cervical compressive myelopathy are gray matter myelomalacia and present with a snake-eye appearance on T2-weighted MR images (T2WI). The disease showed an earlier onset and more rapid progression in the patients with SCECS than in those without SCECS. No significant difference was observed between groups with respect to sex, radiologic findings, or surgical outcomes. These patients were younger than those in the non-SCECS group, and the disease duration from onset to surgery was significantly shorter in the SCECS group than in the non-SCECS group. Seventeen patients (7.9%) were diagnosed with SCECS. Radiographic parameters, demographic characteristics, and the Japanese Orthopedic Association (JOA) surgical outcomes score were compared between the groups. In total, 214 patients with cervical spondylotic myelopathy who underwent surgery between April 2007 and March 2017 were divided into SCECS and non-SCECS groups with SCECS defined as follows: (1) intramedullary signal intensity (ISI) of the cervical spinal cord in sagittal T2WI extending to more than one vertebral body height (2) “fuzzy” ISI, recognized as a faint intramedullary change with a largely indistinct and hazy border and (3) a larger sagittal diameter of the spinal cord segment with ISI just above or below the cord compression area compared with areas of the cervical spine without ISI. We investigated the clinical characteristics of spinal cord edema due to cervical spondylosis (SCECS). doi:10.1016/j.mayocp.2016.06.007.Intramedullary hyperintense lesions associated with spinal cord edema on T2-weighted MR images (T2WI) are rare findings in patients with cervical spondylosis and are poorly characterized. Evidence-based evaluation of complementary health approaches for pain management in the United States. Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Management of non-radicular neck pain in adults. Cervical spondylosis and spondylotic cervical myelopathy. Treatment and prognosis of cervical radiculopathy. American Academy of Orthopaedic Surgeons. Cervical spondylosis (arthritis of the neck).Clinical features and diagnosis of cervical radiculopathy. Evaluation of the patient with neck pain. In: DeLee, Drez, and Miller's Orthopaedic Sports Medicine: Principles and Practice.
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