DTI Of Nerve Root For Quantitative Evaluation Of Neurolysis In Cervical Spondylotic Radiculopathy

Objective:To observe the changes of diffusion tensor imaging(DTI)parameters in patients with radicular cervical spondylosis before and after minimally invasive radiculolysis,and its correlation with visual analogue score and course of disease,and to explore the diagnostic value of DTI in patients with radicular cervical spondylosisMethods:22 patients with CSR were enrolled and underwent routine cervical MRI examination.According to whether the nerve roots were compressed or not,the treated nerve roots(88 roots)were divided into compression group(40 roots)and non-compression group(48 roots).DTI scans and fiber tractorgraphy(FT)were performed before and after minimally invasive neurolysis.The differences of DTI parameters(FA and ADC)between the two groups before and after proceduce were analyzed.The correlation between FA,ADC of nerve roots and VAS score and course of disease was evaluated.Results:(1)In the compression group,There were significant difference of the FA values of all segments and the ADC values of C4,C5 segments between the affected side and the healthy side nerve root before the proceduce(P<0.05).No significant difference were found of the FA and ADC values of all segments after the proceduce(P>0.05).There were significant differences of FA value of C4,C6 segments and ADC value of C4 segment between pre-procedure and post-procedure in compression group(P<0.05),while no significant differences were found in the remaining segments(P>0.05).(2)In the non-compression group,There were significant difference of the FA values of C4,C5,C6 and the ADC values of C4 segments between the affected side and the healthy nerve root before proceduce(P<0.05).There were no significant differences of the FA and ADC values of all segments after proceduce(P>0.05).There were significant differences of FA and ADC value at C4,C5 segments between the pre-procedure and post-procedure in non-compression group(P<0.05),while no significant differences were found in the remaining segments(P>0.05).(3)There were no significant differences in the FA value and ADC value between the compressed nerve root and its adjacent non-compressed nerve root before and after proceduce(P>0.05).(4)There were no correlation between the mean values of FA,ADC with disease course,VAS score neither in compression group nor non-compression group(P>0.05).However,There were positively correlation between the D-value(difference value between affected side and healthy side)in FA of the C5 segment with the disease course at compression group,as well as between the D-value,the ratio(affected side/healthy side)in FA of the C4 segment and the disease course at non-compression group(P<0.05).the D-value in FA of the C6 segment was positively correlated with the VAS score at compression group(P<0.05).Conclusion:DTI can be used to describe the micro structural changes of the corresponding nerve roots before and after neurolysis in CSR,itmay provide a reference for clinical rational selection of treatment ceverical segments.And the D-value of DTI parameters may be used as a more precise indicators for preoperative evaluation and postoperative prediction.