Utility of Dynamic MRI in Surgical Outcome of Patients With Degenerative Cervical Myelopathy: A Single-Center, Randomized Controlled Trial.
Alangsungyu Ajem, Arunkumar Sekar, Suprava Naik et al.
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In 30 seconds
This hospital-based randomized controlled trial assessed whether dynamic MRI (dMRI) could inform surgical planning and outcomes in patients with degenerative cervical myelopathy (DCM), compared with conventional static MRI alone. At 3 months, mean recovery rate was higher with dMRI (55.42% ± 29.05%) than with static MRI (46.76% ± 29.51%; P = .044). A recovery rate of at least 50% occurred in 91.9% versus 59.4% of patients, respectively (P = .002). dMRI changed the surgical plan in 59.5% of cases; longer-term outcomes remain unestablished.
Key findings
- Mean recovery rate at 3 months was 55.42% ± 29.05% with dMRI and 46.76% ± 29.51% with static MRI (P = .044).
- Recovery rate of ≥50% occurred in 91.9% of the dMRI group versus 59.4% of the static MRI group (P = .002).
- Modified Japanese Orthopaedic Association scores were 15.47 ± 2.62 with dMRI and 13.77 ± 2.66 with static MRI (P = .007).
- dMRI altered the surgical plan in 59.5% of cases; the between-group difference in Nurick grade improvement was not statistically significant (P = .151).
Why it matters
Dynamic imaging may reveal cord compression relevant to operative decisions that is not captured by static MRI alone. In this randomized trial, its use was associated with better short-term recovery measures, while the lack of a significant difference in Nurick grade improvement and the short follow-up temper interpretation. The findings add prospective evidence to an area the authors describe as previously unvalidated in randomized trials.
What to keep in mind
Outcomes were assessed at 3 months, so long-term functional effects are unknown. The trial was conducted at a single center.