Diffusion MRI in Cervical Spondylotic Myelopathy (CSM)

Conditions:Neurology, Hematology
Therapuetic Areas:Hematology, Neurology
Age Range:18 - 75
Start Date:January 29, 2018
End Date:June 2022
Contact:Linda Koester, BS

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Predictive Value of Diffusion MRI in Cervical Spondylotic Myelopathy

Patients who have been diagnosed with Cervical Spondylotic Myelopathy will be asked to
undergo an MRI using diffusion basis spectrum imaging (DBSI) technology. The patients will
have this MRI preoperatively and at 24 months postop. The investigators believe that with
this imaging, biomarkers will be able to be seen to assist in prediction of long term
outcomes in patients with spinal cord compression. These patients will be compared to healthy
cohorts who will also undergo an MRI using the DBSI technology.

CSM is the most common form of spinal cord injury and is the leading cause of progressive
disability in patients over the age of 65. A major shortcoming limiting the clinical
management of CSM is the lack of quantifiable metrics to 1) base clinical decisions and 2)
predict potential for functional recovery following surgical intervention. DBSI MRI will
provide imaging biomarkers to more reliably predict a patient's clinical course, response to
therapy, and long-term prognosis.

Patients who are diagnosed with CSM will have an MRI using the DBSI technology preoperatively
and at 24 months. Surgical patients will be assessed with the Neck Disability Index (NDI),
Disability of the Arm, Shoulder and Hand (DASH), hand grip dynamometer and Manual Muscle
Testing (MMT), the modified Japanese Orthopaedic Association scale (mJOA), and the Major
Depression Inventory (MDI), the Short Form-36 (SF-36) and Nurick scoring.

A control group of healthy volunteers will have an MRI using the DBSI technology when
enrolled and then again 24 months later.

Inclusion Criteria:

- History of ongoing spinal cord compression,

- clinical evidence of CSM as determined by signs and symptoms including, but not
limited to loss of manual dexterity, extremity weakness, sensory abnormalities,
quadriparesis, loss of proprioception, and positive Babinski's or Hoffman's sign.

Exclusion Criteria:

- pregnant

- having an MRI incompatible device

- having a known diagnosis of amyotrophic lateral sclerosis, multiple sclerosis,
rheumatoid arthritis, concomitant thoracic and/or lumbar stenosis, spine tumor or
HIV-related myelopathy and having systemic instability or being deemed unable to
tolerate standard MRI sequencing.
We found this trial at
Saint Louis, Missouri 63110
Principal Investigator: Wilson Z Ray, MD
Phone: 314-362-7368
Saint Louis, MO
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