title: Advances in MR imaging for cervical spondylotic myelopathy.
abstract: OBJECTIVE
  To outline the pathogenesis of cervical spondylotic myelopathy (CSM), the correlative abnormalities observed on standard magnetic resonance imaging (MRI), the biological implications and current status of diffusion tensor imaging (DTI), and MR spectroscopy (MRS) as clinical tools, and future directions of MR technology in the management of CSM patients.
  
  
  METHODS
  A systematic review of the pathogenesis and current state-of-the-art in MR imaging technology for CSM was performed.
  
  
  RESULTS
  CSM is caused by progressive, degenerative, vertebral column abnormalities that result in spinal cord damage related to both primary mechanical and secondary biological injuries. The T2 signal change on conventional MRI is most commonly associated with neurological deficits, but tends not to be a sensitive predictor of recovery of function. DTI and MRS show altered microstructure and biochemistry that reflect patient-specific pathogenesis.
  
  
  CONCLUSIONS
  Advanced imaging techniques, including DTI and MRS, show higher sensitivity to microstructural and biochemical changes within the cord, and may aid in management of CSM patients.
authors.affiliation: Department of Radiology, David Geffen UCLA School of Medicine, Los Angeles, USA.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Ellingson
authors.forename: Noriko
authors.initials: N
authors.lastname: Salamon
authors.forename: Langston T
authors.initials: LT
authors.lastname: Holly
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D013118:Spinal Cord Diseases / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D055009:Spondylosis / Q000150:complications / Q000473:pathology* / Q000503:physiopathology
references.citation: Clin Med Res. 2005 Aug;3(3):146-56
references.pmid: 16160069
references.citation: J Neurosurg. 1991 Jun;74(6):887-92
references.pmid: 1903439
references.citation: J Neuropathol Exp Neurol. 1982 Mar;41(2):129-49
references.pmid: 7062084
references.citation: AJNR Am J Neuroradiol. 2012 Feb;33(2):388-92
references.pmid: 22194378
references.citation: Neurobiol Dis. 2009 Feb;33(2):149-63
references.pmid: 19006686
references.citation: Magn Reson Imaging. 2004 Jun;22(5):661-72
references.pmid: 15172060
references.citation: J Magn Reson B. 1994 Mar;103(3):247-54
references.pmid: 8019776
references.citation: Radiology. 2003 Oct;229(1):37-43
references.pmid: 14519868
references.citation: AJNR Am J Neuroradiol. 2013 Feb;34(2):471-8
references.pmid: 22821918
references.citation: NMR Biomed. 2012 May;25(5):795-805
references.pmid: 22020832
references.citation: J Bone Joint Surg Br. 1989 May;71(3):393-8
references.pmid: 2722928
references.citation: Magn Reson Med. 2007 Nov;58(5):880-5
references.pmid: 17969113
references.citation: Acta Radiol. 2012 Oct 1;53(8):921-8
references.pmid: 22893728
references.citation: J Neurosurg. 1975 Jul;43(1):9-17
references.pmid: 1141988
references.citation: Magn Reson Med. 2004 Jun;51(6):1122-8
references.pmid: 15170831
references.citation: Neuroimage. 2011 Apr 1;55(3):1024-33
references.pmid: 21232610
references.citation: Neuroradiology. 2003 Feb;45(2):90-4
references.pmid: 12592491
references.citation: Neurosurgery. 1990 Feb;26(2):217-26 discussion 226-7
references.pmid: 2308669
references.citation: Surg Neurol. 1977 Jul;8(1):63-7
references.pmid: 888079
references.citation: Magn Reson Med. 2006 Jan;55(1):136-46
references.pmid: 16342267
references.citation: Magn Reson Imaging. 2002 Apr;20(3):231-41
references.pmid: 12117605
references.citation: J Neurosurg Spine. 2009 Aug;11(2):119-29
references.pmid: 19769491
references.citation: J Magn Reson Imaging. 1998 Jul-Aug;8(4):775-82
references.pmid: 9702877
references.citation: Spine (Phila Pa 1976). 1996 Apr 1;21(7):827-33
references.pmid: 8779013
references.citation: Biophys J. 1994 Jan;66(1):259-67
references.pmid: 8130344
references.citation: J Neurosurg. 1972 Dec;37(6):631-52
references.pmid: 4654695
references.citation: J Neurosurg Spine. 2007 Dec;7(6):615-22
references.pmid: 18074686
references.citation: Spine (Phila Pa 1976). 1998 Dec 15;23(24):2730-7
references.pmid: 9879098
references.citation: Spine (Phila Pa 1976). 2012 Jan 1;37(1):48-56
references.pmid: 21228747
references.citation: Spine (Phila Pa 1976). 2006 Aug 1;31(17):1867-74
references.pmid: 16924202
references.citation: Spine (Phila Pa 1976). 1999 Mar 1;24(5):455-61; discussion 462
references.pmid: 10084183
references.citation: J Magn Reson B. 1996 Jun;111(3):209-19
references.pmid: 8661285
references.citation: Neurosurg Focus. 2011 Mar;30(3):E14
references.pmid: 21361752
references.citation: Annu Int Conf IEEE Eng Med Biol Soc. 2009;2009:2715-8
references.pmid: 19964039
references.citation: Spine (Phila Pa 1976). 2013 Mar 1;38(5):407-14
references.pmid: 22914703
references.citation: Spine J. 2003 Nov-Dec;3(6):510-9
references.pmid: 14609697
references.citation: Neurosurgery. 2005 May;56(5):1101-13; discussion 1101-13
references.pmid: 15854260
references.citation: AJNR Am J Neuroradiol. 2008 Nov;29(10):1976-82
references.pmid: 18719029
references.citation: Exp Neurol. 2003 Dec;184(2):726-36
references.pmid: 14769364
references.citation: Spine (Phila Pa 1976). 2007 Jul 1;32(15):1675-8; discussion 1679
references.pmid: 17621217
references.citation: Acad Radiol. 2007 Jul;14(7):847-58
references.pmid: 17574135
references.citation: J Neurosurg. 1995 Aug;83(2):336-41
references.pmid: 7616281
references.citation: Spine (Phila Pa 1976). 2002 Jan 1;27(1):21-6
references.pmid: 11805631
references.citation: Eur Radiol. 2012 Aug;22(8):1797-802
references.pmid: 22411307
references.citation: J Magn Reson Imaging. 2009 Mar;29(3):523-8
references.pmid: 19243033
references.citation: Eur Spine J. 2000 Dec;9(6):538-44
references.pmid: 11189924
references.citation: Skeletal Radiol. 2011 Dec;40(12):1543-51
references.pmid: 21494906
references.citation: AJNR Am J Neuroradiol. 2005 Jun-Jul;26(6):1587-94
references.pmid: 15956535
references.citation: Biomed Sci Instrum. 2009;45:167-72
references.pmid: 19369758
references.citation: Eur Radiol. 2011 Feb;21(2):426-33
references.pmid: 20725834
references.citation: Magn Reson Med. 2000 Oct;44(4):625-32
references.pmid: 11025519
references.citation: Eur Spine J. 2011 Mar;20(3):422-8
references.pmid: 20938788
references.citation: Neuroradiology. 2004 Sep;46(9):764-9
references.pmid: 15258708
references.citation: Neuroradiology. 2011 Aug;53(8):609-16
references.pmid: 21344215
references.citation: J Neuroradiol. 2012 Oct;39(4):236-42
references.pmid: 22033418
references.citation: Spine (Phila Pa 1976). 2008 Apr 1;33(7):814-20
references.pmid: 18379411
references.citation: Proc Natl Acad Sci U S A. 2012 Jun 12;109(24):9605-10
references.pmid: 22628562
references.citation: J Magn Reson Imaging. 2006 Feb;23(2):183-8
references.pmid: 16374879
references.citation: Clin Radiol. 2010 Jun;65(6):465-73
references.pmid: 20451014
references.citation: Neuroimage. 2011 Oct 15;58(4):1028-33
references.pmid: 21777679
references.citation: J Neurosurg Spine. 2009 Mar;10(3):194-200
references.pmid: 19320577
references.citation: Spine J. 2006 Nov-Dec;6(6 Suppl):190S-197S
references.pmid: 17097538
references.citation: Ann Neurol. 1999 Feb;45(2):265-9
references.pmid: 9989633
references.citation: J Neurosurg Spine. 2012 Aug;17(2):134-40
references.pmid: 22735048
references.citation: J Neurosci Res. 2006 Apr;83(5):801-10
references.pmid: 16456864
references.citation: Magn Reson Med. 2011 Apr;65(4):927-48
references.pmid: 21337419
references.citation: Magn Reson Med. 1996 Dec;36(6):893-906
references.pmid: 8946355
references.citation: Magn Reson Med. 1997 Mar;37(3):387-94
references.pmid: 9055229
references.citation: J Neurotrauma. 2005 Jan;22(1):138-56
references.pmid: 15665609
references.citation: Arch Neurol. 1969 Dec;21(6):571-89
references.pmid: 5355254
references.citation: NMR Biomed. 1995 Nov-Dec;8(7-8):333-44
references.pmid: 8739270
references.citation: J Magn Reson Imaging. 2005 Jul;22(1):38-43
references.pmid: 15971186
references.citation: Neurol Med Chir (Tokyo). 2006 May;46(5):231-8; discussion 238-9
references.pmid: 16723815
references.citation: J Neurotrauma. 2007 Mar;24(3):481-91
references.pmid: 17402854