Objective: To investigate whether the signal intensity ratio in magnetic resonance imaging (MRI) and clinical manifestations can reflect prognosis in patients with cervical compressive myelopathy.
Methods: Seventy-three patients with cervical compressive myelopathy treated with anterior, posterior, or posterior-anterior united decompression underwent 1.5-T MRI before surgery. T2-weighted images (T2WI) of the sagittal signal intensity on the cervical severe compression cord were obtained, and the regions of interest (ROIs) were taken by 0.05 cm(2). T2-weighted MR images of sagittal normal cord signal on the cervical between C7-T1 disc levels were obtained, and the ROIs were taken by 0.3 cm(2). Signal value is measured by computer and the signal ratio between the regions of the 0.05 cm(2) and 0.3 cm(2) was calculated. If no intramedullary high signal intensity was noted on T2-weighted MR images, the ROIs were taken by 0.05 cm(2) of the severe compression cord. The 73 patients were divided into 3 groups: low, medium, and high signal ratio groups (Group 1, 2, and 3, n = 18, 32, and 23 respectively).
Results: The recovery rate and JOA score of Group 1 were significantly higher, the age and Babinski sign positive rate were significantly lower, and disease duration was shorter in Group 1 than in Groups 2 and 3 (F = 22.009, P < 0.001, F = 5.561, P = 0.006, F = 6.371, P = 0.003, chi(2) = 15.719, P < 0.001, and chi(2) = 13.952, P = 0.001). There was no significant differences in sex among these 3 groups (chi(2) = 1.898, P = 0.387).
Conclusion: The patients with light or without intramedullary signal change on T2WI experience a good surgical outcome. However, the patients with increase of signal intensity ratio and the occurrence of pyramidal sign show a poor prognosis after surgery.