title: Cervical spondylotic myelopathy due to chronic compression: the role of signal intensity changes in magnetic resonance images.
abstract: OBJECTIVE
  Although there is agreement that low-intensity signal changes on T1-weighted magnetic resonance (MR) images are a prognostic factor for poor outcome after surgical treatment of cervical myelopathy due to chronic cord compression, the role of high-intensity signal changes on T2-weighted images is still controversial. The aim of the present study was to determine whether T2-weighted MR imaging can help assess the prognosis of the disease.
  
  
  METHODS
  A prospective case series study was conducted. The population comprised 67 patients who underwent surgery between 1994 and 2004 to treat myelopathy caused by chronic cervical cord compression. The mean follow-up period was 39 months. Preoperative and postoperative functional status was evaluated using a modified Japanese Orthopaedic Association scale, and the recovery rate was calculated using the Hirabayashi method. Magnetic resonance images were acquired 3 months or less before surgery. High-intensity signal changes were evaluated according to the extent of these changes on T2-weighted sequences; low-intensity T1-weighted signal changes were also evaluated. In patients with low-intensity changes on T1-weighted images and in those with high-intensity changes spanning multiple levels on T2-weighted images, the authors documented a poor functional recovery.
  
  
  CONCLUSIONS
  Multisegmental high-intensity change on T2-weighted MR imaging is a more sensitive indicator of outcomes than T1-weighted signal changes because of its higher frequency in patients with advanced myelopathy.
authors.affiliation: Department of Spinal Surgery, University Hospital Virgen de la Victoria, Málaga, Spain.
authors.forename: Juan Jose
authors.initials: JJ
authors.lastname: Fernández de Rota
authors.forename: Stephan
authors.initials: S
authors.lastname: Meschian
authors.forename: Antonio
authors.initials: A
authors.lastname: Fernández de Rota
authors.forename: Victor
authors.initials: V
authors.lastname: Urbano
authors.forename: Manuel
authors.initials: M
authors.lastname: Baron
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009187:Myelitis / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D011182:Postoperative Care; D011300:Preoperative Care; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function; D012720:Severity of Illness Index; D013117:Spinal Cord Compression / Q000150:complications* / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D013166:Spondylitis / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D017211:Treatment Failure