title: Hypermetabolism in 18F-FDG PET predicts favorable outcome following decompressive surgery in patients with degenerative cervical myelopathy.
abstract: The aim of this study was to prospectively assess the regional changes of glucose metabolism of the cervical spinal cord in patients with degenerative cervical spine stenosis and symptomatic cervical myelopathy after decompressive surgery using (18)F-FDG PET.
  
  
  METHODS
  Twenty patients with symptomatic degenerative monosegmental cervical stenosis with neuroradiologic signs of spinal cord compression underwent decompressive surgery. The clinical course using a functional status score (Japanese Orthopedic Association [JOA] score), (18)F-FDG uptake, and MR imaging were assessed before and at follow-up 12 mo after surgery. Pre- and postoperative changes of (18)F-FDG PET were correlated to the patients' clinical outcome.
  
  
  RESULTS
  Ten patients demonstrated preoperatively a focally increased (18)F-FDG uptake at the level of the stenosis. At follow-up, the uptake declined significantly (P = 0.008), and a significant improvement of JOA scores (P < 0.001) could be observed. The remaining 10 patients were characterized preoperatively by an inconspicuous glucose uptake at the level of cord compression in combination with a poststenotic decrease of (18)F-FDG uptake. At follow-up, both JOA scores and (18)F-FDG uptake changed insignificantly.
  
  
  CONCLUSIONS
  Focal glucose hypermetabolism at the level of cervical spinal cord compression may predict an improved outcome after surgical decompression. Thus, this finding on (18)F-FDG PET suggests a functional damage in a reversible phase of cervical myelopathy.
authors.affiliation: Department of Neurosurgery, University Düsseldorf, Düsseldorf, Germany.
authors.forename: Frank W
authors.initials: FW
authors.lastname: Floeth
authors.forename: Norbert
authors.initials: N
authors.lastname: Galldiks
authors.forename: Sven
authors.initials: S
authors.lastname: Eicker
authors.forename: Gabriele
authors.initials: G
authors.lastname: Stoffels
authors.forename: Jörg
authors.initials: J
authors.lastname: Herdmann
authors.forename: Hans-Jakob
authors.initials: HJ
authors.lastname: Steiger
authors.forename: Gerald
authors.initials: G
authors.lastname: Antoch
authors.forename: Sascha
authors.initials: S
authors.lastname: Rhee
authors.forename: Karl-Josef
authors.initials: KJ
authors.lastname: Langen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000601:surgery*; D013130:Spinal Stenosis / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18F-FDG PET; cervical myelopathy; compression-induced inflammatory response; degenerative cervical spinal stenosis; spinal cord recovery