The role of neuronal plasticity in cervical spondylotic myelopathy surgery: functional assessment and prognostic implication

Neurosurgical Review, 2023 · DOI: https://doi.org/10.1007/s10143-023-02062-9 · Published: June 26, 2023

Spinal Cord Injury Surgery Neuroplasticity

Simple Explanation

Cervical spondylotic myelopathy (CSM) is a condition where the spinal cord in the neck is compressed, leading to neurological problems. Surgery is often used to treat CSM, but how the brain recovers after surgery isn't fully understood. This review looks at how the brain reorganizes itself (neuroplasticity) before and after surgery in CSM patients. It explores how techniques like fMRI and diffusion MRI can help us understand these changes. Understanding neuroplasticity in CSM could help doctors predict how well patients will recover after surgery and tailor treatments to improve outcomes.

Study Duration

Not specified

Participants

240 patients

Evidence Level

Review

Key Findings

1
Functional MRI (fMRI) can be used to evaluate neural plasticity, showing changes in cortical networks due to spinal cord injury and cerebral reorganization.
2
DTI-tractography allows the noninvasive measurement of water diffusion, providing information such as fractional anisotropy (FA) in different tissues and measuring their integrity.
3
Navigated transcranial magnetic stimulation (nTMS) has proven to be a valuable tool in characterizing functional impairment in patients affected by cervical myelopathy.

Research Summary

This review examines the role of neuronal plasticity in cervical spondylotic myelopathy (CSM) surgery, focusing on functional assessment and prognostic implications. The study analyzes various imaging modalities, including fMRI, DTI, and TMS, to assess cortical reorganization and recovery patterns before and after surgery in CSM patients. The review concludes that understanding neural plasticity and utilizing advanced imaging techniques could improve the prediction of surgical outcomes and tailor treatments for CSM patients.

Practical Implications

Improved Prognosis Prediction

Advanced imaging techniques can help predict patient recovery after CSM surgery.

Personalized Treatment

Understanding neuroplasticity allows tailoring treatments to enhance recovery.

Refined Surgical Approaches

Further research can identify optimal surgical approaches based on cortical reorganization patterns.

Study Limitations

1
Studies heterogeneity and small sample sizes limit generalization of results.
2
Different methods used to assess functional reorganization make interpretation difficult.
3
Nonunique definition of cervical myelopathy.

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