Feasibility of H-MR Spectroscopy in evaluation of cervical spondylotic myelopathy

Purpose

To assess the diagnostic value of magnetic resonance spectroscopy (MRS) in the evaluation of cervical spinal cord biochemical changes in patients with cervical spondylotic myelopathy (CSM).

Materials and methods

Twenty-four patients with cervical spondylotic myelopathy (patient group) and eleven age matched neurologically free volunteers (control group) underwent magnetic resonance imaging. MRS was assessed for the main metabolites including N-acetylaspartate (NAA), Choline (Cho), Creatine (Cr) and Lactate (Lac). The MRS findings of both groups were compared.

Results

Significant reduction in NAA/Cr ratio of patients with CSM (mean = 1.34 ± 0.09) in comparison to controls (mean = 1.82 ± 0.08). No significant differences in Cho/Cr ratio between both groups. Lactate peak was detected in nine patients while it was not detected in any of the controls. The difference in NAA/Cr ratio between patients with Lac peak and those without Lac peak was insignificant.

Conclusion

MRS is a promising non invasive technique that can help to evaluate metabolic changes of the cervical cord in cervical spondylotic myelopathy even in normally looking-areas.