Association Between Spinal Canal Sagittal Diameter Dynamics and T2- Weighted MRI Intramedullary Hyperintensity in Cervical Spondylotic Myelopathy Patients

Abstract

Abstract Objective This study aimed to explore the dynamic changes in the spinal canal sagittal diameter and their association with increased intramedullary signal intensity on MRI T2-weighted imaging (T2WI) in patients with cervical spondylotic myelopathy (CSM), providing clinical guidance for diagnosing and selecting appropriate treatment approaches.Materials and Methods Clinical data from 72 patients diagnosed with CSM and treated at the Third Hospital of Hebei Medical University were collected and subjected to comparative analysis. The patients were divided into two groups based on the signal intensity on preoperative cervical MRI T2WI (Group I, which exhibited hyperintensity, and Group II, which showed no signal changes). Statistical analysis was conducted comparing the two groups in terms of gender, lesion segment, age, BMI, duration of symptoms, preoperative JOA score, spinal cord compression rate, cervical curvature, total cervical ROM, intervertebral space ROM, and the sagittal diameter of the cervical spinal canal in lateral, hyperextension, and hyperflexion positions.Results The study included 40 males and 32 females, with an average age of 51.49 ± 7.23 years. No significant differences were found in age, BMI, symptom duration, preoperative JOA score, spinal cord compression rate, cervical physiological curvature, total cervical ROM, intervertebral space ROM, and the distribution of gender and segment (p>0.05). However, both the total superior and inferior variation values of the cervical canal sagittal diameter during neck flexion and extension activities were significantly lower in Group I than in Group II (p = 0.001), indicating negative changes. The interobserver reliability was high.Conclusion The dynamics of the sagittal diameter of the cervical spinal canal play a crucial role in the progression of CSM. This aspect should be given significant attention and can inform the assessment and selection of clinical treatment plans for patients with CSM.