Hyperkyphosis
Conditions
Brief summary
Spinal cord compression is commonly seen in patients with severe kyphosis. However, conventional morphologic magnetic resonance imaging (MRI) was unable to detect the damage in microstructural integrity of the spinal cord around the apical vertebrae in these patients. The aim of the study was to evaluate the neuronal metrics/microstructure of the spinal cord around apical region in patients with hyperkyphosis using diffusion tensor imaging (DTI).
Detailed description
Spinal cord compression is commonly seen in patients with severe kyphosis. However, conventional morphologic magnetic resonance imaging (MRI) was unable to detect the damage in microstructural integrity of the spinal cord around the apical vertebrae in these patients. The aim of the study was to evaluate the neuronal metrics/microstructure of the spinal cord around apical region in patients with hyperkyphosis using diffusion tensor imaging (DTI). Twenty-four patients with hyperkyphosis aged 46.1±22.8 years who underwent 3.0T MRI examination with DTI sequence were prospectively enrolled from July 2022 to January 2023. Patients were divided into three groups according to spinal cord/cerebrospinal fluid architecture (CSF) on sagittal-T2 MRI of the thoracic apex: Type A-circular cord with visible CSF, Type B-circular cord but no visible CSF at apical dorsal, and Type C-spinal cord deformed without intervening CSF. The Fractional Anisotropy (FA) values acquired from DTI were compared among different groups. Correlations between DTI parameters and global kyphosis (GK)/sagittal deformity angular ratio (SDAR) were evaluated using Pearson correlation coefficients.
Interventions
RADIATIONVariation in anisotropy of the Spinal Cord using diffusion tensor imaging
All examinations were performed on a 3.0-T MRI machine with a 12-channel spine special coil (Ingenia CX, Philips Healthcare, Best, the Netherlands). The multi-sequence MRI protocol included conventional T1-weighted (sag & tra), T2-weighted (sag & tra), and DTI sequence.
Sponsors
The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
11 Years to 78 Years
Healthy volunteers
No
Inclusion criteria
* diagnosis of hyperkyphosis; * the apex located at the thoracal region (T1-T12); * full DTI data; * records of detailed and systematic neurological physical examination.
Exclusion criteria
* any case with active infection, tumor, or trauma; * any cases of comorbidity of neurofibromatosis type I; * any cases combined with spinal syringomyelia, split cord malformations or diastematomyelia, tethered cord syndrome; * previous spinal surgery.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fractional anisotropy (FA) values | preoperative | Raw DTI data were postprocessed on FuncTool (GE) software. After an initial correction of geometric distortions, the color-coded FA maps were generated. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Global kyphosis (GK) in degrees | preoperative | Measured on anteroposterior and lateral radiographs and defined as the angle from upper to lower most tilted end vertebrae. |
| Sagittal deformity angular ratio (SDAR) | preoperative | Divided GK by the number of levels spanning the curve. |
Countries
China
Outcome results
None listed