Abstract
The aim of this study was to prospectively assess the regional changes of glucose metabolism of the cervical spinal cord in patients with degenerative cervical spine stenosis and symptomatic cervical myelopathy after decompressive surgery using 18F-FDG PET. Methods: Twenty patients with symptomatic degenerative monosegmental cervical stenosis with neuroradiologic signs of spinal cord compression underwent decompressive surgery. The clinical course using a functional status score (Japanese Orthopedic Association [JOA] score), 18F-FDG uptake, and MR imaging were assessed before and at follow-up 12 mo after surgery. Pre- and postoperative changes of 18F-FDG PET were correlated to the patients’ clinical outcome. Results: Ten patients demonstrated preoperatively a focally increased 18F-FDG uptake at the level of the stenosis. At follow-up, the uptake declined significantly (P = 0.008), and a significant improvement of JOA scores (P < 0.001) could be observed. The remaining 10 patients were characterized preoperatively by an inconspicuous glucose uptake at the level of cord compression in combination with a poststenotic decrease of 18F-FDG uptake. At follow-up, both JOA scores and 18F-FDG uptake changed insignificantly. Conclusion: Focal glucose hypermetabolism at the level of cervical spinal cord compression may predict an improved outcome after surgical decompression. Thus, this finding on 18F-FDG PET suggests a functional damage in a reversible phase of cervical myelopathy.
- cervical myelopathy
- degenerative cervical spinal stenosis
- spinal cord recovery
- 18F-FDG PET
- compression-induced inflammatory response
Footnotes
↵* Contributed equally to this work.
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- © 2013 by the Society of Nuclear Medicine and Molecular Imaging, Inc.