{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T23:36:46Z","timestamp":1790897806719,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,6,14]],"date-time":"2014-06-14T00:00:00Z","timestamp":1402704000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To highlight a specific under\u2010recognized radiological feature of spondylotic myelopathy often resulting in misdiagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients evaluated between January 1, 1996 and December 31, 2012 who met the following criteria were included: (1) spondylotic myelopathy was suspected, (2) gadolinium enhancement was detected, and (3) spinal surgery was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010six patients (70% men) whose median age was 53.5 years (range\u2009=\u200924\u201380) were included. Spinal cord magnetic resonance imaging (cervical in 52; thoracic in 4) revealed longitudinal spindle\u2010shaped T2\u2010signal hyperintensity (100%) and cord enlargement (79%) accompanied by a characteristic pancakelike transverse band of gadolinium enhancement in 41 (73%), typically immediately caudal to the site of maximal spinal stenosis. Forty (71%) patients were initially diagnosed with neoplastic or inflammatory myelopathies, and decompressive surgery was delayed by a median of 11 months (range\u2009=\u20091\u201364). Spinal cord biopsy in 6 did not reveal any alternative diagnosis. Ninety\u2010five percent were stable or improved. Gadolinium enhancement persisted in 75% at 12 months, raising concern about the accuracy of the initial diagnosis. Twenty patients required a gait aid (36%) at last follow\u2010up (median\u2009=\u200960 months, range\u2009=\u200910\u2013172). The need for a gait aid preoperatively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), but not delay of surgery, predicted the need for gait aid at final follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Transverse pancakelike gadolinium enhancement associated with and just caudal to the site of maximal stenosis and at the rostrocaudal midpoint of a spindle\u2010shaped T2 hyperintensity suggests that spondylosis is the cause of the myelopathy. Persistent enhancement for months to years following decompressive surgery is common. Recognition is important to prevent inappropriate interventions or delay in consideration of a potentially beneficial decompressive surgery. Ann Neurol 2014;76:54\u201365<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.24184","type":"journal-article","created":{"date-parts":[[2014,5,16]],"date-time":"2014-05-16T13:08:44Z","timestamp":1400245724000},"page":"54-65","source":"Crossref","is-referenced-by-count":101,"title":["Specific pattern of gadolinium enhancement in spondylotic myelopathy"],"prefix":"10.1002","volume":"76","author":[{"given":"Eoin P.","family":"Flanagan","sequence":"first","affiliation":[{"name":"Departments of Neurology Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl N.","family":"Krecke","sequence":"additional","affiliation":[{"name":"Departments of Radiology Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard W.","family":"Marsh","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Giannini","sequence":"additional","affiliation":[{"name":"Departments of Anatomical Pathology Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. Mark","family":"Keegan","sequence":"additional","affiliation":[{"name":"Departments of Neurology Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian G.","family":"Weinshenker","sequence":"additional","affiliation":[{"name":"Departments of Neurology Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,6,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3100422"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2012.09.003"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.173.1.2781011"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2009.152"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318293e346"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/NRL.0b013e3181c29f12"},{"key":"e_1_2_7_8_1","unstructured":"SasamoriT HidaK YanoS et al.Spinal cord swelling with abnormal gadolinium\u2010enhancement mimicking intramedullary tumors in cervical spondylosis patients: three case reports and review of the literature.Asian J Neurosurg2010;5:1\u20139."},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.70.10.899"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31822b00b9"},{"issue":"1","key":"e_1_2_7_11_1","first-page":"8","article-title":"Spinal cord edema: unusual magnetic resonance imaging findings in cervical spondylosis","volume":"99","author":"Lee J","year":"2003","journal-title":"J Neurosurg"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e318166f5a6"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004728-199307000-00007"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/94.3.557"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000046587.83503.1E"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.57.7.1074"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2005.11.022"},{"key":"e_1_2_7_18_1","first-page":"944","article-title":"Acute disseminated encephalomyelitis, transverse myelitis, and neuromyelitis optica","volume":"19","author":"Wingerchuk DM","year":"2013","journal-title":"Continuum (Minneap Minn)"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.3109\/02688697.2011.633636"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2012.09.004"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000053223.77641.5E"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.20.6.g00nv151721"},{"key":"e_1_2_7_23_1","doi-asserted-by":"crossref","unstructured":".FlanaganEP HuntCH LoweV et al.[(18)F]\u2010fluorodeoxyglucose\u2010positron emission tomography in patients with active myelopathy.Mayo Clin Proc2013;88:1204\u20131212.","DOI":"10.1016\/j.mayocp.2013.07.019"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.111.091801"}],"container-title":["Annals of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fana.24184","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ana.24184","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T11:49:22Z","timestamp":1696592962000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ana.24184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,6,14]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2014,7]]}},"alternative-id":["10.1002\/ana.24184"],"URL":"https:\/\/doi.org\/10.1002\/ana.24184","archive":["Portico"],"relation":{},"ISSN":["0364-5134","1531-8249"],"issn-type":[{"value":"0364-5134","type":"print"},{"value":"1531-8249","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,6,14]]}}}