ArticleFrontiers in neurology2022
Can preoperative cervical spinal diffusion tensor imaging (DTI) indices predict surgical outcomes in patients with Hirayama disease? A retrospective cohort study.
Article in Frontiers in neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Anterior cervical discectomy and fusion (ACDF) surgery can effectively prevent disease progression in patients with Hirayama disease (HD) and diffusion tensor imaging (DTI) can quantitatively assess spinal cord function. In this study, we aimed to evaluate the relationship between preoperative spinal DTI indices and the clinical outcomes of patients with HD when treated by ACDF. Methods: We retrospectively analyzed 35 HD patients treated by ACDF. We collated a range of DTI indices, including fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values, prior to surgery with patients in flexion and neutral positions. Patients were divided into improvement (Im) group and non-improvement (Nim) group according to the Odom score, and the difference in surgical outcomes between the two groups was confirmed by quick disabilities of the arm, shoulder and hand (Q-DASH) scores. The DTI indices in the two groups of patients were then compared. Receiver operating characteristic (ROC) curves and area under curve (AUC) were used to evaluate the predictive capability. The correlation between Q-DASH scores and DTI indices was also evaluated. Results: The FA values in the two groups of patients differed significantly in the cervical flexion position and the different segments were mainly located in the lower cervical spinal cord including the flexion C5/6 (Im group vs. Nim group: 0.501 ± 0.078 vs. 0.362 ± 0.087, Conclusion: Preoperative DTI indices of the spinal cord, especially those of the lower cervical spinal cord with patients in the flexion position, can predict the clinical outcome of patients with HD post-surgery. In general, a larger FA value and a smaller ADC value indicate a better surgical outcome.
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