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High field structural MRI in the management of degenerative cervical myelopathy.

Wright, D; Martin, S; Pereira, EA; Kong, Y; Tracey, I; Cadoux-Hudson, T (2018) High field structural MRI in the management of degenerative cervical myelopathy. Br J Neurosurg, 32 (6). pp. 595-598. ISSN 1360-046X https://doi.org/10.1080/02688697.2018.1467371
SGUL Authors: Pereira, Erlick Abilio Coelho

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Abstract

INTRODUCTION: This is a narrative overview of the pathophysiology, investigation and management of Degenerative Cervical Myelopathy (DCM). This review article also takes a look ahead to the impact high resolution MRI may have on treatment. BACKGROUND: DCM is the most common cause of spinal dysfunction and yet it remains poorly understood. It is becoming increasingly common in our ageing population. Disc and facet joint abnormalities, osteophytes, spondylothisthesis and ligamentous hypertrophy all act together to produce spinal canal and neuronal foramina stenosis which in turn causes neural compromise. Its impact on the quality of life of this patient group and the wider economy is vast. Some patients with overt cord compression and MRI signal change in their cervical cord may only have subtle clinical signs whilst others with less striking imaging may be profoundly myelopathic. Who to operate on and when remains a neurosurgical dilemma in this group of patients. METHODS: A number of articles with a broad variation in methodology were reviewed and referenced during the production of this paper. RESULTS: This paper is a narrative review. The results presented in all the referenced articles were considered. CONCLUSION: The process of developing new imaging techniques will give a greater understanding of the causes of the symptoms of DCM and in a wider context facilitate further surgical and medical strategies that are more cost effective and beneficial to patients. The advent of 7T MRI or further optimisation of safer 3T MRI sequences may soon provide this opportunity and the diagnostic gap in spinal cord imaging can begin to close.

Item Type: Article
Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis in British Journal of Neurosurgery on 24/4/18, available online: http://www.tandfonline.com/10.1080/02688697.2018.1467371
Keywords: Upper cervical spine, neurosurgery, spinal, spinal cord, spinal cord compression, Upper cervical spine, neurosurgery, spinal, spinal cord, spinal cord compression, Neurology & Neurosurgery, 1103 Clinical Sciences, 1109 Neurosciences
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Br J Neurosurg
ISSN: 1360-046X
Language: eng
Dates:
DateEvent
24 April 2018Published
16 April 2018Accepted
Publisher License: Publisher's own licence
PubMed ID: 29688066
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/110017
Publisher's version: https://doi.org/10.1080/02688697.2018.1467371

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