{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:33:18Z","timestamp":1790008398840,"version":"4.0.1"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2009,3]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Magnetic resonance spectroscopy is commonly used to provide cellular and metabolic information in the management of a variety of pathological processes that affect the brain, and its application recently has been expanded to the cervical spine. The majority of radiographic investigations into the pathophysiology of cervical spondylotic myelopathy (CSM) have been focused on the spinal cord macrostructure. The authors sought to determine the feasibility of using MR spectroscopy to analyze spinal cord biochemical function in patients with CSM.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Twenty-one patients with clinical and radiographic evidence of CSM were prospectively enrolled in this study. The patients underwent preoperative neurological examination, functional assessment, and cervical spine MR spectroscopy. Voxels were placed at the C-2 level, and the MR spectroscopy spectra peaks for <jats:italic>N<\/jats:italic>-acetylaspartate (NAA), choline, lactate (Lac), and creatine (Cr) were measured. Thirteen age-matched healthy volunteers served as controls.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The NAA\/Cr ratio was significantly lower in patients with CSM than in controls (1.27 vs 1.83, respectively, p &lt; 0.0001). The choline\/Cr ratio was not significantly different between the 2 groups. Seven of the patients with CSM had a Lac peak, whereas no peaks were noted in the control group (p &lt; 0.05). There was no correlation between the severity of myelopathy and the NAA\/Cr ratio in the CSM cohort.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Data in this study demonstrated the feasibility of using MR spectroscopy to evaluate the cellular biochemistry of the spinal cord in patients with CSM. Patients with CSM had a significantly lower NAA\/Cr ratio than healthy controls, likely because of axonal and neuronal loss. The presence of Lac peaks in one-third of the patients in the CSM cohort further supports the role of ischemia in the pathophysiology of CSM.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2008.12.spine08367","type":"journal-article","created":{"date-parts":[[2011,2,23]],"date-time":"2011-02-23T21:40:20Z","timestamp":1298497220000},"page":"194-200","source":"Crossref","is-referenced-by-count":70,"title":["Proton magnetic resonance spectroscopy to evaluate spinal cord axonal injury in cervical spondylotic myelopathy"],"prefix":"10.3171","volume":"10","author":[{"given":"Langston T.","family":"Holly","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonnie","family":"Freitas","sequence":"additional","affiliation":[{"name":"Radiology, David Geffen School of Medicine at the University of California at Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"McArthur","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriko","family":"Salamon","sequence":"additional","affiliation":[{"name":"Radiology, David Geffen School of Medicine at the University of California at Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0100194","series-title":"Neuroimaging","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1111\/j.1552-6569.2007.00119.x","article-title":"Clinical and MRI predictors of outcome after surgical intervention for cervical spondylotic myelopathy","volume":"17","author":"Alafifi","year":"2007"},{"key":"b2-0100194","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1227\/00006123-198805000-00004","article-title":"Analysis of cervical spine curvature in patients with cervical spondylosis","volume":"22","author":"Batzdorf","year":"1988"},{"key":"b3-0100194","series-title":"J Spinal Disord","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1097\/00002517-199109000-00005","article-title":"Cervical laminectomy and dentate ligament section for cervical spondylotic myelopathy","volume":"4","author":"Benzel","year":"1991"},{"key":"b4-0100194","series-title":"Magn Reson Med","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1002\/mrm.1910290605","article-title":"The proton NMR spectrum in acute EAE: the significance of the change in the Cho:Cr ratio","volume":"29","author":"Brenner","year":"1993"},{"key":"b5-0100194","series-title":"Magn Reson Med","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1002\/mrm.21382","article-title":"Axonal damage in the spinal cord of multiple sclerosis patients detected by magnetic resonance spectroscopy","volume":"58","author":"Blamire","year":"2007"},{"key":"b6-0100194","series-title":"J Neurotrauma","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1089\/neu.2006.23.674","article-title":"Early morphologic and spectroscopic magnetic resonance in severe traumatic brain injuries can detect \u201cinvisible brain stem damage\u201d and predict \u201cvegetative states\u201d","volume":"23","author":"Carpentier","year":"2006"},{"key":"b7-0100194","series-title":"Magn Reson Med","doi-asserted-by":"publisher","first-page":"1122","DOI":"10.1002\/mrm.20084","article-title":"Quantitative proton magnetic resonance spectroscopy of the cervical spinal cord","volume":"51","author":"Cooke","year":"2004"},{"key":"b8-0100194","series-title":"J Bone Joint Surg Br","first-page":"393","article-title":"The prognosis of surgery for cervical compression myelopathy. 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