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Correlation Between Pre-Operative Diffusion Tensor Imaging Indices and Post-Operative Outcome in Degenerative Cervical Myelopathy: A Systematic Review and Meta-Analysis Publisher



Mohammadi M1 ; Roohollahi F2, 3 ; Mahmoudi MM4 ; Mohammadi A1 ; Mohamadi M1 ; Kankam SB5, 6 ; Ghamari Khameneh A7 ; Baghdasaryan D8 ; Farahbakhsh F9 ; Martin AR10 ; Harrop J11 ; Rahimimovaghar V9, 12, 13, 14, 15
Authors
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Authors Affiliations
  1. 1. School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Yas Spine Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of General Surgery, Shahid Mofateh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. Image guided Neurosurgery Lab, Department of Neurosurgery, Brigham and Women Hospital, Harvard Medical School, Boston, MA, United States
  6. 6. Brain Trauma Lab, Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
  7. 7. Department of Radiology, Advanced Diagnostic and Interventional Radiology (ADIR) Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Nairi Medical Center, Yerevan, Armenia
  9. 9. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  10. 10. Department of Neurosurgery, University of California Davis, Davis, CA, United States
  11. 11. Department of Neurological and Orthopedic Surgery, Thomas Jefferson University, Philadelphia, PA, United States
  12. 12. Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  13. 13. Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  14. 14. Universal Scientific Education and Research Network (USERN), Tehran, Iran
  15. 15. Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran

Source: Global Spine Journal Published:2024


Abstract

Study Design: Systematic review. Objectives: The correlation between pre-operative diffusion tensor imaging (DTI) metrics and post-operative clinical outcomes in patients with degenerative cervical myelopathy (DCM) has been widely investigated with different studies reporting varied findings. We conducted a systematic review to determine the association between DTI metric and clinical outcomes after surgery. Methods: We identified relevant articles that investigated the relationship between pre-operative DTI indices and post-operative outcome in DCM patients by searching PubMed/MEDLINE, Web of Science, Scopus, and EMBASE from inception until October 2023. In addition, quantitative synthesis and meta-analyses were performed. Results: FA was significantly correlated with postoperative JOA or mJOA across all age and follow up subgroups, changes observed in JOA or mJOA from preoperative to postoperative stages (Δ JOA or Δ mJOA) in subgroups aged 65 and above and in those with a follow-up period of 6 months or more, as well as recovery rate in all studies pooled together and also in the under-65 age bracket. Additionally, a significant correlation was demonstrated between recovery rate and ADC across all age groups. No other significant correlations were discovered between DTI parameters (MD, AD, and ADC) and post-operative outcomes. Conclusion: DTI is a quantitative noninvasive evaluation tool that correlates with severity of DCM. However, the current evidence is still elusive regarding whether DTI metric is a validated tool for predicting the degree of post-operative recovery, which could potentially be useful in patient selection for surgery. © The Author(s) 2024.
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