title: Correlation of diffusion tensor imaging parameters with neural status in Pott's spine.
abstract: BACKGROUND
  Diffusion tensor imaging (DTI) has been used in cervical trauma and spondylotic myelopathy, and it has been found to correlate with neural deficit and prognosticate neural recovery. Such a correlation has not been studied in Pott's spine with paraplegia. Hence, this prospective study has been used to find correlation of DTI parameters with neural deficit in these patients.
  
  
  METHODS
  Thirty-four patients of spinal TB were enrolled and DTI was performed before the start of treatment and after six months. Fractional anisotropy (FA), Mean diffusivity (MD), and Tractography were studied. Neurological deficit was graded by the Jain and Sinha scoring. Changes in FA and MD at and below the site of lesion (SOL) were compared to above the SOL (control) using the unpaired t-test. Pre-treatment and post-treatment values were also compared using the paired t-test. Correlation of DTI parameters with neurological score was done by Pearson's correlation. Subjective assessment of Tractography images was done.
  
  
  RESULTS
  Mean average FA was not significantly decreased at the SOL in patients with paraplegia as compared to control. After six months of treatment, a significant decrease (p = 0.02) in mean average FA at the SOL compared to pre-treatment was seen. Moderate positive correlation (r = 0.49) between mean average FA and neural score after six months of treatment was found. Tractography images were not consistent with severity of paraplegia.
  
  
  CONCLUSIONS
  Unlike spondylotic myelopathy and trauma, epidural collection and its organized inflammatory tissue in Pott's spine precludes accurate assessment of diffusion characteristics of the compressed cord.
authors.affiliation: University College of Medical Sciences & GTB Hospital 110095 Delhi India.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Jain
authors.affiliation: Department of Radiology, Institute of Nuclear Medicine and Allied Sciences (INMAS) 110054 Delhi India.
authors.forename: Namita Singh
authors.initials: NS
authors.lastname: Saini
authors.affiliation: Sharda University 201306 Greater Noida India.
authors.forename: Sudhir
authors.initials: S
authors.lastname: Kumar
authors.affiliation: University College of Medical Sciences & GTB Hospital 110095 Delhi India.
authors.forename: Mukunth
authors.initials: M
authors.lastname: Rajagopalan
authors.affiliation: Department of Radiology, Institute of Nuclear Medicine and Allied Sciences (INMAS) 110054 Delhi India.
authors.forename: Kanti Lal
authors.initials: KL
authors.lastname: Chakraborti
authors.affiliation: University College of Medical Sciences & GTB Hospital 110095 Delhi India.
authors.forename: Anil Kumar
authors.initials: AK
authors.lastname: Jain
keywords: DTI; Diffusion tensor imaging; Pott’s spine; Spinal tuberculosis