Clinical Trial: DTI of the Brain and Cervical Spine: Evaluation in Normal Subjects and Patients With Cervical Spondylotic Myelopathy

Study Status: Completed
Recruit Status: Completed
Study Type: Observational

Official Title: Diffusion Tensor Imaging of the Brain and Cervical Spine: Evaluation of Reproducibility in Normal Subjects and Diagnostic Utility in Patients With Cervical Spondylotic Myelopathy

Brief Summary: More than half of the middle-aged population has radiologic evidence of cervical spondylosis (Irvine 1965) and a subset of this population develops cervical spondylotic myelopathy (CSM), a condition in which the spinal cord is impaired, either by direct mechanical compression or indirectly by arterial deprivation and/or venous stasis. In this study we aim to test the hypothesis that diffusion tensor imaging can provide prognostic information on the integrity of the spine in these patients which is unavailable from conventional MRI images

Detailed Summary:

More than half of the middle-aged population has radiologic evidence of cervical spondylosis and a subset of this population develops cervical spondylotic myelopathy (CSM), a condition in which the spinal cord is impaired, either by direct mechanical compression or indirectly by arterial deprivation and/or venous stasis. Although many operations are performed for conditions related to CSM, no consensus exists regarding the timing of the surgical intervention or how to select among the available surgical options for a given patient. Many factors have been implicated in the propensity for CSM to develop including advanced age, disability at presentation, cord diameter, cord area, altered cord signal on MRI (T2- and T1- weighted images), increased cervical spinal mobility and a congenitally narrow spinal canal. The same factors may also determine the response to surgery, either positively (increased cervical mobility) or negatively (advanced age, congenitally narrow spinal canal). The potential complications of surgical procedures are noteworthy. Although incapacitating adverse effects are uncommon, their occurrence in a disease process with a potentially benign course is of undoubted gravity. Finally, it should be noted that the radiologic criteria of cervical root or cord compression on MRI are subjective and it is uncertain that they correlate with the clinical symptoms.

Diffusion tensor imaging (DTI) is sensitive to the motion of water and is considered to be a marker for axonal integrity in the brain. There has been much interest in applying the technique to the spine and in particular to the evaluation of patients with CSM. In the brain DTI is performed using a single shot echo planar imaging (SS-EPI) sequence which acquires all of the data for a single slice following the application of a single excitation pulse and diffusion gradients. While very efficient in terms o
Sponsor: Emory University

Current Primary Outcome: Diffusion properties of the spinal cord [ Time Frame: The diffusion properties are measured in a single imaging session lasting approximately 50 minutes. ]

Original Primary Outcome: Diffusion properties of the spinal cord [ Time Frame: The diffsuion properties are measured in a single imaging session lasting approximately 50 minutes. ]

Current Secondary Outcome:

Original Secondary Outcome:

Information By: Emory University

Dates:
Date Received: May 13, 2013
Date Started: January 2013
Date Completion:
Last Updated: July 14, 2015
Last Verified: July 2015