To use advanced imaging techniques, including MRI Brain and Spinal Cord, and MRI/PET Spinal Cord to provide an assessment of Degenerative Cervical Myelopathy to improve understanding of the pathophysiology and natural history of DCM.
Degenerative Cervical Myelopathy (DCM) is a disabling condition affecting up to 2% of adults. It arises when arthritic changes in the cervical spine compress and injure the spinal cord, causing progressive loss of bodily function. Surgery will remove compression and stop injury. However, for a full recovery, it must occur before irreversible spinal cord damage. Current assessments cannot provide this information and today, 95% of patients are left disabled: an assessment that measures spinal cord damage would change this tomorrow. Imaging advances, well established for measuring disease of the brain, have the potential to provide this in DCM, but requires further investigation. This is the subject of this proposed application: specifically, to investigate 3 different but promising imaging approaches for the assessment of DCM: 1. Advanced magnetic resonance imaging (MRI) to image within the spinal cord 2. Advanced MRI to measure the changes that occur within the brain following DCM 3. Positron Emission Tomography (PET) to measure the active disease biology within the spinal cord. Individuals with a diagnosis of DCM, will be invited to undergo one of these options, before and after their surgical treatment. Clinical measures used in routine practice will be noted, in order to draw comparisons with imaging. A healthy control group will also be used for MRI imaging, in order to identify changes specific to DCM. Aside from the additional imaging, there will be no changes in routine care.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
100
Patients will undergo either Magnetic Resonance Imaging of the Spinal Cord
Patients will undergo combination MRI/PET using a \[11C\]PIB radiotracer
3T MR Imaging of the Brain
Cambridge University Hospital
Cambridge, Cambridgeshire, United Kingdom
RECRUITINGModified Japanese Orthopaedics Association (mJOA)
Time frame: 6 Months Post Surgery
Short-Form 36 (SF-36)
Quality of Life (0-100, where 50 is normal for geographical population. Higher score is better)
Time frame: Routine Clinical Care: Baseline and 3-6 Months Post-Operatively
Numeric Rating Scale (NRS) Pain
Pain Score (0-10, where 10 is maximum pain, and 0 is no pain. Lower score is better)
Time frame: Routine Clinical Care: Baseline and 3-6 Months Post-Operatively
Myelopathy.org Symptom Inventory [MOSI]
Quality of Life and Disease Specific Measure (Range of Myelopathy symptoms are scored as Not present, on an intensity scale of 0 to 10, where 10 is worse).
Time frame: Routine Clinical Care: Baseline and 3-6 Months Post-Operatively
Neurological Exam
Routine Neurological Exam (Motor and Sensory changes to hands, arms and legs, long-tract signs in cluded reflexes, Hoffman's and Babbinski's reflexes)
Time frame: Routine Clinical Care: Baseline and 3-6 Months Post-Operatively
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7T MR Imaging of the Spinal Cord