title: Quantitative assessment of column-specific degeneration in cervical spondylotic myelopathy based on diffusion tensor tractography.
abstract: OBJECTIVE
  Cervical spondylotic myelopathy (CSM) is a common spinal cord disorder in the elderly. Diffusion tensor imaging (DTI) has been shown to be of great value for evaluating the microstructure of nerve tracts in the spinal cord. Currently, the quantitative assessment of the degeneration on the specific tracts in CSM is still rare. The aim of the present study was to use tractography-based quantification to investigate the column-specific degeneration in CSM.
  
  
  METHODS
  A total of 43 volunteers were recruited with written informed consent, including 20 healthy subjects and 23 CSM patients. Diffusion MRI was taken by 3T MRI scanner. Fiber tractography was performed using TrackVis to reconstruct the white matter tracts of the anterior, lateral and posterior column on the bilateral sides. The DTI metrics acquired from tractography, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD), were compared between healthy subjects and CSM patients.
  
  
  RESULTS
  Compared to healthy subjects, FA was found significantly lower in the lateral (Healthy 0.64 ± 0.07 vs. CSM 0.53 ± 0.08) and posterior column (Healthy 0.67 ± 0.08 vs. CSM 0.47 ± 0.08) (p < 0.001), while MD, AD and RD were significantly higher in the anterior, lateral and posterior column in CSM (p < 0.05).
  
  
  CONCLUSIONS
  Loss of microstructural integrity was detected in the lateral and posterior column in CSM. Tractography-based quantification was capable of evaluating the subtle pathological insult within white matter on a column-specific basis, which exhibited potential clinical value for in vivo evaluation of the severity of CSM.
authors.affiliation: Department of Orthopaedics and Traumatology, The University of Hong Kong, 12 Sandy Bay Road, Pokfulam, Hong Kong.
authors.forename: Jiao-Long
authors.initials: JL
authors.lastname: Cui
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
authors.forename: Tin-Yan
authors.initials: TY
authors.lastname: Chan
authors.forename: Kin-Cheung
authors.initials: KC
authors.lastname: Mak
authors.forename: Keith Dip-Kei
authors.initials: KD
authors.lastname: Luk
authors.forename: Yong
authors.initials: Y
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D016880:Anisotropy; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000473:pathology*; D002908:Chronic Disease; D038524:Diffusion Magnetic Resonance Imaging; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013117:Spinal Cord Compression / Q000209:etiology / Q000473:pathology*; D055009:Spondylosis / Q000150:complications / Q000473:pathology*; D066127:White Matter / Q000473:pathology