Neurosurgery 97:681–690, 2025
This study used diffusion tensor imaging to assess spinal cord tract integrity in degenerative cervical myelopathy (DCM). Significant injury was found in the lateral corticospinal tract, fasciculus gracilis, and fasciculus cuneatus, suggesting these are key tracts affected in DCM, while other tracts may support compensatory recovery.
• Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction, often resulting in persistent motor deficits despite surgery.
• This study used diffusion tensor imaging (DTI) and atlas-based analysis to assess specific spinal cord tract integrity in DCM patients versus healthy controls.
• Fractional anisotropy (FA) was significantly reduced in the lateral corticospinal tract, fasciculus gracilis, and fasciculus cuneatus in DCM patients compared to healthy volunteers.
• No significant FA differences were found between mild and moderate-to-severe DCM patients for any tract.
• Most other spinal tracts, including reticulospinal and rubrospinal, showed no significant FA changes, suggesting possible preservation and compensatory potential.
• Limitations include small sample size, age differences between groups, and inability to analyze tracts at the site of maximal compression.
• Findings suggest injury to specific tracts in DCM, with other tracts as potential targets for future therapies and compensatory recovery.
• Further studies with larger cohorts and improved imaging are needed to validate and expand these results.
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