title: The clinical usefulness of preoperative dynamic MRI to select decompression levels for cervical spondylotic myelopathy.
abstract: The study subjects included 54 patients with cervical spondylotic myelopathy who underwent a selective laminoplasty. The patients were divided into three groups according to the number of decompressed levels: two levels, three levels and four or five levels. The number of cord compressions at every intervertebral level was determined in the flexion, neutral, and extension position using a dynamic magnetic resonance imaging (MRI) scan in consideration of both static and dynamic compressions. For each group, the clinical outcomes were evaluated. Moreover, the patients were divided into two groups according to their age. Then, the appearance ratios of cord compression between the neutral and extension position were compared at each intervertebral level. The clinical outcomes were satisfactory. There were no statistical differences among the three groups, except for the age and operation time. The position of the neck influenced the number of cord compressions. The appearance ratios of cord compression, which were especially prominent at C2/3, C3/4 and C4/5, showed high scores in the aged. The preoperative dynamic MRI scan was clinically useful. In the aged, attention should be given to C2/3, C3/4 and C4/5.
authors.affiliation: Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan. t-harada@koto.kpu-m.ac.jp
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Harada
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Tsuji
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Mikami
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Hatta
authors.forename: Atsuto
authors.initials: A
authors.lastname: Sakamoto
authors.forename: Takumi
authors.initials: T
authors.lastname: Ikeda
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tamai
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hase
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Kubo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D013117:Spinal Cord Compression / Q000150:complications / Q000601:surgery*; D055009:Spondylosis / Q000150:complications / Q000601:surgery*