ArticleNeurosurgery2025
Diffusion MRI Metrics Characterize Postoperative Clinical Outcomes After Surgery for Cervical Spondylotic Myelopathy.
Article in Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Racial/Ethnic Disparities in Health Literacy, Perception of Health Status, and Access to Healthcare Among Heart Transplant Patients of the National Institutes of Health All of Us Research Program.Journal of racial and ethnic health disparities · 2026Article
- Disparities in quality of life and health literacy among patients with degenerative cervical myelopathy: the influence of racial and ethnic factors in the All of Us Research Program.Journal of neurosurgery. Spine · 2026Article
- Article
- Association between preoperative activity levels and postoperative complications in adult spinal deformity surgery.Spine deformity · 2025Article
- Prevalence of Sleep Disturbance and Associated Risk Factors in Degenerative Cervical Myelopathy.Journal of clinical medicine · 2025Article
- Influence of Preoperative Depression on Cervical Spine Surgery Outcomes: A Systematic Review and Meta-Analysis.Global spine journal · 2025Review
- The Role of the Glymphatic System in Cervical Spondylotic Myelopathy: Insights From Advanced Imaging.Clinical spine surgery · 2025Article
- Outcome of spine surgery in the context of spinal metastatic disease: The National Surgical Quality Improvement Program.Journal of craniovertebral junction & spineArticle
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Authors and funding
16 authors.
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Abstract
BACKGROUND AND
objectivesAdvanced diffusion-weighted MRI (DWI) modeling, such as diffusion tensor imaging (DTI) and diffusion basis spectrum imaging (DBSI), may help guide rehabilitation strategies after surgical decompression for cervical spondylotic myelopathy (CSM). Currently, however, postoperative DWI is difficult to interpret, owing to signal distortions from spinal instrumentation. Therefore, we examined the relationship between postoperative DTI/DBSI-extracted from the rostral C3 spinal level-and clinical outcome measures at 2-year follow-up after decompressive surgery for CSM.
methodsFifty patients with CSM underwent complete clinical and DWI evaluation-followed by DTI/DBSI analysis-at baseline and 2-year follow-up. Clinical outcomes included the modified Japanese Orthopedic Association score and comprehensive patient-reported outcomes. DTI metrics included apparent diffusion coefficient, fractional anisotropy, axial diffusivity, and radial diffusivity. DBSI metrics evaluated white matter tracts through fractional anisotropy, fiber fraction, axial diffusivity, and radial diffusivity as well as extra-axonal pathology through restricted and nonrestricted fraction. Cross-sectional Spearman's correlations were used to compare postoperative DTI/DBSI metrics with clinical outcomes.
resultsTwenty-seven patients with CSM, including 15, 7, and 5 with mild, moderate, and severe disease, respectively, possessed complete baseline and postoperative DWI scans. At 2-year follow-up, there were 10 significant correlations among postoperative DBSI metrics and postoperative clinical outcomes compared with 3 among postoperative DTI metrics. Of the 13 significant correlations, 7 involved the neck disability index (NDI). The strongest relationships were between DBSI axial diffusivity and NDI (r = 0.60, P < .001), DBSI fiber fraction and NDI (r s = -0.58, P < .001), and DBSI restricted fraction and NDI (r s = 0.56, P < .001). The weakest correlation was between DTI apparent diffusion coefficient and NDI (r = 0.35, P = .02).
conclusionQuantitative measures of spinal cord microstructure after surgery correlate with postoperative neurofunctional status, quality of life, and pain/disability at 2 years after decompressive surgery for CSM. In particular, DBSI metrics may serve as meaningful biomarkers for postoperative disease severity for patients with CSM.
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