| Changes in functional magnetic resonance imaging cortical activation after decompression of cervical spondylosis: case report. | |
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MedLine Citation:
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PMID: 20657323 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND IMPORTANCE: Spinal cord compression may induce cortical reorganization. This study follows a patient with cervical spondylotic myelopathy to investigate changes in cortical activation before and after decompressive surgery. The relationship with functional recovery is also described. CLINICAL PRESENTATION: A 37-year-old right-hand-dominant man presented a 1-month history of rapidly worsening right-hand clumsiness, right-sided hemiparesis, and gait difficulties. Physical examination confirmed severe right-sided weakness, impaired dexterity, hyperreflexia, and wide-based gait. The patient underwent blood oxygenation level-dependent functional magnetic resonance imaging at 4 T. Images were obtained before and 6 months after an anterior cervical discectomy with insertion of an artificial disk. Blood oxygenation level-dependent functional magnetic resonance imaging was used to detect changes in cortical activation over time during a finger-tapping (motor) paradigm. Improvement in clinical function was recorded with validated clinical tools, including the Japanese Orthopedic Association scale for cervical spondylotic myelopathy, the Nurick neurological function score, and the Neck Disability Index, along with clinical examination. CONCLUSION: After decompressive cervical spine surgery in a patient with cervical spondylotic myelopathy, functional magnetic resonance imaging detected increased cortical activation in the primary motor cortex during finger tapping. These changes occurred concomitantly with improvement in motor function. Upper- and lower-extremity motor subscores of the Japanese Orthopedic Association scale demonstrated 40% and 43% improvement, respectively. These observations suggest that cortical reorganization or recruitment may accompany the recovery of function after spinal cord injury. |
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Authors:
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Samantha Tam; Robert L Barry; Robert Bartha; Neil Duggal |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Neurosurgery Volume: 67 ISSN: 1524-4040 ISO Abbreviation: Neurosurgery Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-23 Completed Date: 2011-05-17 Revised Date: 2011-08-25 |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: E863-4; discussion E864 Citation Subset: IM |
Affiliation:
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Division of Neurosurgery, London Health Sciences Center, London, Ontario, Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Humans Male Motor Cortex / physiopathology* Neuronal Plasticity / physiology* Paresis / etiology, physiopathology*, surgery Recovery of Function / physiology* Spinal Cord Compression / etiology, physiopathology*, surgery Spondylosis / complications, physiopathology*, surgery |
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