Diffusion tensor imaging observation in potts spine with/without neurological deficit
|IJOCP | Volume – 2015| Issue – 2015| Article ID – 2015:104
Conference: Indian Orthopaedic Association Annual Conference IOACON-2013, India [Click for Full details]
Authors: ABBAS S S, Jain A K, Saini N S, Kumar S, Iyer M
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Introduction: DTI is based upon the phenomenon of water diffusion known as “Brownian Motion”. DTI can detect changes in compressed spinal cord earlier than MRI and is more sensitive to subtle pathological changes of the spinal cord. DTI observation in compressed and non-compressed spinal cord in TB spine is not described. We present observations in 30 consecutive patients of TB spine.
Materials and Methods: Thirty cases of TB spine, mean age 32.1 years of both sexes with paradiscal lesion, with/without paraplegia divided into two groups: Group A: (n=15) without paraplegia and Group B: (n=15) with paraplegia were evaluated by DTI. The average Fractional Anisotropy (FA) and Mean Diffusivity (MD) values were calculated at3 different sites, above site of lesion (SOL)/normal, at the lesion and below SOL for both groups and mean was compared. Visual impression oftractography was done to document changes in spinal tracts.
Results: The mean canal encroachment in group A was 39.60% and group B 44.4% (insignificant). Group A average FA means (above SOL, at the lesion and below SOL) were 0.608±0.09, 0.554± 0.14 and 0.501±0.16. For group B, average FA means (above SOL, at the lesion and below SOL) were 0.628±0.09, 0.614±0.12 and 0.487±0.15. There was significant difference in mean average FA above the SOL as compared to the mean average FA at and below SOL. P value above vs below the SOL was statistically significant for both groups. (0.04), but p value for at vs below the SOL (0.01) was statistically significant only in Group B. On tractography, disruption of fiber tract at SOL was found in 14/15 (93.3%) cases of group A and 14/15 cases (93.3%) of group B (6/6 grade 4, 3/3 grade 3 and 5/6 grade 2 paraplegic cases).
Conclusion: The FA and MD above the lesion were same as reported for healthy volunteer hence can be taken as control. FA increases and MD decreases at SOL in severe grade of paraplegia because of epidural collection while in milder grade, both decrease. In group A, mean FA and MD in patients with and without canal encroachment was similar. On tractography, both groups A and B showed disruption of fiber tract at SOL and thickness of distally traced spinal cord was appreciably less than the upper cord. FA and MD could not differentiate between various grades of paraplegia. Although number of patients in each groups are small.
|How to Cite this Abstract|
|ABBAS S S, Jain A K, Saini N S, Kumar S, Iyer M. Diffusion tensor imaging observation in potts spine with/without neurological deficit. International Journal of Conference Proceedings 2015;(2015):104|