학술논문

Imaging and Electrophysiology for Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 9]
Document Type
article
Source
Global Spine Journal. 12(1_suppl)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Neurodegenerative
Clinical Research
Neurosciences
Spinal Cord Injury
Physical Injury - Accidents and Adverse Effects
Biomedical Imaging
Traumatic Head and Spine Injury
4.2 Evaluation of markers and technologies
Detection
screening and diagnosis
4.1 Discovery and preclinical testing of markers and technologies
Neurological
cervical myelopathy
imaging
diagnosis
electrophysiology
spinal cord compression
magnetic resonance
neural damage
microstructure
assessment
Clinical sciences
Language
Abstract
Study designNarrative review.ObjectiveThe 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.MethodsA narrative review was conducted to summarize the existing literature and highlight future directions.ResultsAnatomical 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.ConclusionCurrently, 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.