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Imaging and Electrophysiology for Degenerative Cervical Myelopathy [Ao Spine Recode-Dcm Research Priority Number 9] Publisher



Martin AR1 ; Tetreault L2 ; Nouri A3 ; Curt A4 ; Freund P4 ; Rahimimovaghar V5 ; Wilson JR6 ; Fehlings MG6 ; Kwon BK7 ; Harrop JS8 ; Davies BM9 ; Kotter MRN9 ; Guest JD10 ; Aarabi B11 Show All Authors
Authors
  1. Martin AR1
  2. Tetreault L2
  3. Nouri A3
  4. Curt A4
  5. Freund P4
  6. Rahimimovaghar V5
  7. Wilson JR6
  8. Fehlings MG6
  9. Kwon BK7
  10. Harrop JS8
  11. Davies BM9
  12. Kotter MRN9
  13. Guest JD10
  14. Aarabi B11
  15. Kurpad SN12
Show Affiliations
Authors Affiliations
  1. 1. Department of Neurological Surgery, University of California Davis, Davis, CA, United States
  2. 2. Department of Neurology, New York University, Langone Health, Graduate Medical Education, New York, NY, United States
  3. 3. Division of Neurosurgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
  4. 4. University Spine Center, Balgrist University Hospital, Zurich, Switzerland
  5. 5. Department of Neurosurgery, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
  7. 7. Vancouver Spine Surgery Institute, Department of Orthopedics, The University of British Columbia, Vancouver, BC, Canada
  8. 8. Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, United States
  9. 9. Department of Neurosurgery, University of Cambridge, Cambridge, United Kingdom
  10. 10. Department of Neurosurgery and The Miami Project to Cure Paralysis, The Miller School of Medicine, University of Miami, Miami, FL, United States
  11. 11. Department of Neurosurgery, University of Maryland, Baltimore, MD, United States
  12. 12. Department of Neurosurgery, Medical College of Wisconsin, Wauwatosa, WI, United States

Source: Global Spine Journal Published:2022


Abstract

Study Design: Narrative review. Objective: The current review aimed to describe the role of existing techniques and emerging methods of imaging and electrophysiology for the management of degenerative cervical myelopathy (DCM), a common and often progressive condition that causes spinal cord dysfunction and significant morbidity globally. Methods: A narrative review was conducted to summarize the existing literature and highlight future directions. Results: Anatomical magnetic resonance imaging (MRI) is well established in the literature as the key imaging tool to identify spinal cord compression, disc herniation/bulging, and inbuckling of the ligamentum flavum, thus facilitating surgical planning, while radiographs and computed tomography (CT) provide complimentary information. Electrophysiology techniques are primarily used to rule out competing diagnoses. However, signal change and measures of cord compression on conventional MRI have limited utility to characterize the degree of tissue injury, which may be helpful for diagnosis, prognostication, and repeated assessments to identify deterioration. Early translational studies of quantitative imaging and electrophysiology techniques show potential of these methods to more accurately reflect changes in spinal cord microstructure and function. Conclusion: Currently, clinical management of DCM relies heavily on anatomical MRI, with additional contributions from radiographs, CT, and electrophysiology. Novel quantitative assessments of microstructure, perfusion, and function have the potential to transform clinical practice, but require robust validation, automation, and standardization prior to uptake. © The Author(s) 2021.
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