title: Proton magnetic resonance spectroscopy of human cervical spondylosis at 3T.
abstract: METHODS
  A single-center magnetic resonance imaging and spectroscopic study involving 21 patients with advanced cervical spondylosis and 11 healthy controls.
  
  
  OBJECTIVE
  We assessed the utility of magnetic resonance spectroscopy (MRS) to quantify biochemical changes within the spinal cord and serve as a potential biomarker in patients with cervical spondylosis with or without T2 hyperintensity within the cord.
  
  
  METHODS
  Los Angeles, California, USA.
  
  
  METHODS
  Twenty-one patients with cervical spondylosis and eleven healthy controls were evaluated. Single-voxel MRS was performed in the cervical cord. Morphometry of the spinal canal space was measured. N-Acetyl aspartylglutamic acid (NAA), choline (Cho), myo-inositol (Myo-I), glutamine-glutamate complex (Glx) and lactate metabolite concentration ratios with respect to total creatine (Cr) were quantified using an LC model algorithm and compared between healthy controls and spondylosis patients. Correlation of MRS metabolites with modified Japanese Orthopaedic Association (mJOA) score was also performed.
  
  
  RESULTS
  The spinal canal space was significantly different between patients and controls (analysis of variance (ANOVA), P<0.0001). Total Cho-to-Cr ratio was significantly elevated in patients with spondylosis and T2-hyperintensity compared with healthy controls (ANOVA, P<0.01). A significantly higher Cho-to-NAA ratio was observed in spondylosis patients compared with healthy controls (ANOVA, P<0.01). Slightly elevated Glx and Myo-I were encountered in patients with stenosis without T2 hyperintensity. A linear correlation between Cho-NAA ratio and mJOA was also observed (P<0.01).
  
  
  CONCLUSIONS
  MRS appears sensitive to biochemical changes occurring in advanced cervical spondylosis patients. The Cho/NAA ratio was significantly correlated with the mJOA score, providing a potentially clinically useful radiographical biomarker for the management of advanced cervical spondylosis patients.
authors.affiliation: Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: N
authors.initials: N
authors.lastname: Salamon
authors.forename: B M
authors.initials: BM
authors.lastname: Ellingson
authors.forename: R
authors.initials: R
authors.lastname: Nagarajan
authors.forename: N
authors.initials: N
authors.lastname: Gebara
authors.forename: A
authors.initials: A
authors.lastname: Thomas
authors.forename: L T
authors.initials: LT
authors.lastname: Holly
mesh_terms: D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D002794:Choline / Q000032:analysis*; D003401:Creatine / Q000032:analysis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008875:Middle Aged; D011522:Protons; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055009:Spondylosis / Q000175:diagnosis* / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D011522:Protons; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline