Neurosurgery
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Percutaneous cordotomy for intractable cancer pain has variable efficacy. One potential cause is the inability to quantify neural ablation. Diffusion tensor imaging (DTI) can quantify microstructural changes within the spinal cord after neural injury. We aimed to determine if DTI metrics within the spinal cord could quantify neural ablation and evaluate early postoperative outcomes. ⋯ DTI of the spinal cord was sensitive to the number of lesions as well as early improvement in pain scores after cordotomy. DTI of the cervical spinal cord is a potential biomarker of neural ablation after percutaneous cordotomy for intractable cancer pain, and may have a role in evaluating patients with a poor outcome after cordotomy.
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Degenerative cervical myelopathy (DCM) encompasses a spectrum of age-related conditions that result in progressive spinal cord injury through static and dynamic injury mechanisms. Through detailed review of MRIs from prospective AOSpine multicenter studies, the global prevalence of degenerative cervical pathologies of surgically treated DCM patients is reported. ⋯ DCM pathologies, including OPLL, are highly interrelated and rarely present in isolation. Females presented with milder evidence of DCM on MRI. There are also variances in the spectrum and prevalence of pathologies between geographical regions and these may be due to a multitude of causes.