title: Spinal cord edema: unusual magnetic resonance imaging findings in cervical spondylosis.
abstract: OBJECTIVE
  Spinal cord edema is a rare radiological finding in chronic degenerative disorders of the spine. Between 1997 and 2001, the authors treated six patients with cervical spondylotic myelopathy in whom postoperative spinal cord edema was demonstrated. The authors describe the radiological and clinical features of this unusual condition.
  
  
  METHODS
  The six patients were all men, and ranged in age from 44 to 72 years. All patients presented with mild quadriparesis and underwent laminoplasty or anterior fusion. Preoperative magnetic resonance (MR) imaging revealed marked spinal cord compression with intramedullary hyperintensity on T2-weighted sequences and spinal cord enhancement at the compression level after administration of Gd. After surgery, spinal cord edema was observed in all patients; the spinal cord appeared swollen on the postoperative MR images. Preoperative and postoperative Gd-enhanced MR imaging demonstrated clear enhancement of the white matter at the compressed segment Neurologically, five of six patients experienced good improvement of symptoms; however, the spinal cord edema as documented on follow-up MR imaging persisted for several months after surgery.
  
  
  CONCLUSIONS
  The radiological characterization of spinal cord edema was based on the reversible white matter lesion most likely caused by disturbed local venous circulation induced by chronic spinal cord compression. Such unusual MR findings in cervical spondylotic myelopathy should be differentiated from intramedullary spinal cord tumors, demyelinating disorders, or inflammatory processes.
authors.affiliation: Department of Neurosurgery, Sapporo Medical University School of Medicine, Japan.
authors.forename: Jangbo
authors.initials: J
authors.lastname: Lee
authors.forename: Izumi
authors.initials: I
authors.lastname: Koyanagi
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Hida
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Seki
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Kenji
authors.initials: K
authors.lastname: Mitsumori
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae; D004487:Edema / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011782:Quadriplegia / Q000209:etiology; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000209:etiology*; D013128:Spinal Osteophytosis / Q000175:diagnosis / Q000601:surgery*