PLASTICITY OF THE SPINAL-CORD CONTRIBUTES TO NEUROLOGICAL IMPROVEMENTAFTER TREATMENT BY CERVICAL DECOMPRESSION - A MAGNETIC-RESONANCE-IMAGING STUDY

To investigate the relationship between morphological plasticity of th e spinal cord and neurological outcome after surgery for compressive l esions, we correlated the transverse area of the cervical spinal cord measured by transaxial magnetic resonance imaging (MRI) obtained durin g the early postoperative period (1-6 months) with neurological functi on assessed at a median postoperative follow-up period of 2.5 years. M easurements on MRI in 56 patients (35 men and 21 women) included evalu ation of the cross-sectional area of the cervical cord and the subarac hnoidal space at the level of decompression. The transverse area of th e cervical cord increased by 30 to 62% postoperatively and that of the subarachnoidal space by 57 to 95%. Neurological improvement was noted in all patients and averaged 63% in our assessment scale. Expansion o f the cervical cord during the early postoperative period correlated s ignificantly with the late postoperative neurological status (P = 0.00 9). Our results suggest that an increase in the cross-sectional area o f the cervical spinal cord, representing spinal cord morphological pla sticity, is a significant factor in determining the late neurological improvement following decompressive surgery.