The effect of intramedullary signal intensity in MRI on the therapeutic efficacy of posterior cervical decompression laminectomy with internal fixation and fusion for multi-level cervical spondylotic myelopathy : a retrospective cohort study

Abstract

We aimed to investigate the effect of intramedullary signal intensity in MRI on the therapeutic efficacy of posterior cervical decompression laminectomy with fixation for multi-level cervical spondylotic myelopathy.

Fifty-six patients were retrospectively analyzed in two experimental groups: signal (-) group (n=41) and signal (+) group (n=15). JOA scores, Borden values, Cobb angles, disc space heights, and adjacent disc space heights of the cervical spine were measured to evaluate the neurological functional recovery rate.

The effective rate in the spinal cord signal (-)/(+) group was 95.1%/86.7% and the excellent (or good) rate was 85.4% (or 20.0%). A rank-sum test revealed a significant difference between the JOA score improvement rates of the signal (+) and signal (-) groups. Analyses of variance showed that the Borden values and Cobb angles, but not the disc space heights and inter-vertebral space heights, collected at these four time points were statistically different.

The signal (-) group improvement rate was higher than that of the signal (+) group despite the fact that posterior cervical decompression laminectomy with fixation effectively improved the overall neurological functions in all MCSM patients. Furthermore, the surgery provided good cervical stability throughout the whole observation period.