Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Diffusion Tensor Imaging in Diagnosing and Evaluating Degenerative Cervical Myelopathy: A Systematic Review and Meta-Analysis Publisher



Mohammadi M1 ; Roohollahi F2, 3 ; Farahbakhsh F4 ; Mohammadi A1 ; Mortazavi Mamaghani E1 ; Kankam SB5, 6 ; Moarrefdezfouli A4 ; Ghamari Khameneh A7 ; Mahmoudi MM8 ; Baghdasaryan D9 ; Martin AR10 ; Harrop J11 ; Rahimimovaghar V4, 12, 13, 14, 15
Authors
Show Affiliations
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. Sina Trauma and Surgery Research Center, Tehran 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. Department of General Surgery, Shahid Mofateh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  9. 9. Nairi Medical Center, Yerevan, Armenia
  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:2025


Abstract

Study Design: Systematic review. Objective: Degenerative cervical myelopathy (DCM) is a common spinal cord disorder necessitating surgery. We aim to explore how effectively diffusion tensor imaging (DTI) can distinguish DCM from healthy individuals and assess the relationship between DTI metrics and symptom severity. Methods: We included studies with adult DCM patients who had not undergone decompressive surgery and implemented correlation analyses between DTI parameters and severity, or compared healthy controls and DCM patients. Results: 57 studies were included in our meta-analysis. At the maximal compression (MC) level, fractional anisotropy (FA) exhibited lower values in DCM patients, while apparent diffusion coefficient (ADC), mean diffusivity (MD), and radial diffusivity (RD) were notably higher in the DCM group. Moreover, our investigation into the diagnostic utility of DTI parameters disclosed high sensitivity, specificity, and area under the curve values for FA (.84,.80,.83 respectively) and ADC (.74,.84,.88 respectively). Additionally, we explored the correlation between DTI parameters and myelopathy severity, revealing a significant correlation of FA (.53, 95% CI:0.40 to.65) at MC level with JOA/mJOA scores. Conclusion: Current guidelines for DCM suggest decompressive surgery for both mild and severe cases. However, they lack clear recommendations on which mild DCM patients might benefit from conservative treatment vs immediate surgery. ADC’s role here could be pivotal, potentially differentiating between healthy individuals and DCM. While it may not correlate with symptom severity, it might predict surgical outcomes, making it a valuable imaging biomarker for clearer management decisions in mild DCM. © The Author(s) 2024.
Related Docs
1. Imaging and Electrophysiology for Degenerative Cervical Myelopathy [Ao Spine Recode-Dcm Research Priority Number 9], Global Spine Journal (2022)
2. Correlation Between Pre-Operative Diffusion Tensor Imaging Indices and Post-Operative Outcome in Degenerative Cervical Myelopathy: A Systematic Review and Meta-Analysis, Global Spine Journal (2024)
3. Improving Awareness Could Transform Outcomes in Degenerative Cervical Myelopathy [Ao Spine Recode-Dcm Research Priority Number 1], Global Spine Journal (2022)
4. Ao Spine Clinical Practice Recommendations for Diagnosis and Management of Degenerative Cervical Myelopathy: Evidence Based Decision Making - a Review of Cutting Edge Recent Literature Related to Degenerative Cervical Myelopathy, Global Spine Journal (2025)
5. A New Framework for Investigating the Biological Basis of Degenerative Cervical Myelopathy [Ao Spine Recode-Dcm Research Priority Number 5]: Mechanical Stress, Vulnerability and Time, Global Spine Journal (2022)
Experts (# of related papers)
Vafa Rahimi-Movaghar (5)