title: Effectiveness of Riluzole as a pharmacotherapeutic treatment option for early cervical myelopathy: a double-blinded, placebo-controlled randomised controlled trial.
abstract: To evaluate the effectiveness of Riluzole as a pharmacotherapeutic treatment option for early cervical myelopathy using clinical parameters and DTI analysis.
  
  
  
  Early cervical myelopathy cases with MJOA scores ≥13, were recruited for the double-blinded, placebo-controlled randomised control trial. Thirty cases with fifteen cases each in the test and placebo group were studied. Analysis was done using diffusion tensor imaging (DTI) and clinical evaluation, pre- and post-institution of sodium channel blocker Riluzole for a period of 1 month (50 mg twice daily). Placebo group was treated with Vitamin B complex tablets. Diffusion co-efficient fractional anisotrophy (FA), apparent diffusion co-efficient (ADC), volume ratio (VR), relative anisotrophy (RA) and Eigen vectors were calculated. Outcomes analysis was based on clinical scores of MJOA, Nurick grading, SF-12, NDI, and statistical analysis of DTI datametrics.
  
  
  
  The mean MJOA score was 15.6 (13-17) with no significant change in the test and control groups. The mean ADC, FA values were 1533.36 (1238-1779) and 494.36 (364-628) and changed to 1531.57 (1312-2091) and 484.86 (294-597), respectively, in the Riluzole group. However, the changes in the values of ADC, FA, and other co-efficients including VR, RA and eigenvectors in the two groups were not statistically significant. The functional scores in the SF-12 and NDI questionnaires did not change significantly.
  
  
  
  Our study did not show a significant change in the clinical outcome and DTI Indices with the use of Riluzole as a standalone pharmacotherapeutic agent for early cervical myelopathy. More studies may be needed to confirm the usefulness of Riluzole as a treatment option for cervical myelopathy.
authors.affiliation: Department of Spine Surgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641043, India. sr@gangahospital.com.
authors.forename: S
authors.initials: S
authors.lastname: Rajasekaran
authors.affiliation: Department of Spine Surgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641043, India.
authors.forename: Siddharth N
authors.initials: SN
authors.lastname: Aiyer
authors.affiliation: Department of Spine Surgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641043, India.
authors.forename: Ajoy Prasad
authors.initials: AP
authors.lastname: Shetty
authors.affiliation: Department of Spine Surgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641043, India.
authors.forename: Rishi Mugesh
authors.initials: RM
authors.lastname: Kanna
authors.affiliation: Department of Spine Surgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641043, India.
authors.forename: Anupama
authors.initials: A
authors.lastname: Maheswaran
authors.affiliation: Department of Spine Surgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641043, India.
authors.forename: Janardhan Yerram
authors.initials: JY
authors.lastname: Shetty
mesh_terms: D056324:Diffusion Tensor Imaging; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D018696:Neuroprotective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019782:Riluzole / Q000008:administration & dosage / Q000627:therapeutic use; D013118:Spinal Cord Diseases / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D018696:Neuroprotective Agents; D019782:Riluzole
keywords: Diffusion tensor imaging; Early cervical myelopathy; Riluzole