Does dynamic supine magnetic resonance imaging improve the diagnostic accuracy of cervical spondylotic myelopathy? A review of the current evidence.

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Does dynamic supine magnetic resonance imaging improve the diagnostic accuracy of cervical spondylotic myelopathy? A review of the current evidence.

World Neurosurg. 2017 Jan 24;:

Authors: Xu N, Wang S, Yuan H, Liu X, Liu Z

Abstract
PURPOSE: We aimed to critically analyze the current evidence regarding the role of dynamic supine MRI (dsMRI) in the evaluation of cervical spondylotic myelopathy (CSM).
METHODS: 13 studies were identified through a comprehensive literature search performed in the PubMed, EMBASE, and ISI databases as fulfilling the inclusion criteria and were reviewed for subject characteristics, radiographical parameters, and salient findings.
RESULTS: Studies herein reviewed suggested that dsMRI was able to detect new appearance or increased grade of medullary compression in at least 20% of patients and to demonstrate an average narrowing of the cervical canal by 20% (in comparison to the neutral position). Several additional parameters were investigated but their clinical significance remained unconfirmed. Two studies examined how surgical decision-making could be affected by the additional findings of dsMRI.
CONCLUSIONS: dsMRI represents an available modification of conventional static MRI and is potentially able to demonstrate pathologies that might be previously missed. Evidence suggests that dsMRI can elucidate spinal cord compression with higher sensitivity, resulting in improved diagnostic accuracy of CSM, which may impact surgical planning for these patients. However, more high-quality studies are required to further establish its indications to avoid over-diagnosis with this powerful imaging technique and to justify its cost-effectiveness.

PMID: 28130164 [PubMed - as supplied by publisher]

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