{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:39:42Z","timestamp":1788964782238,"version":"build-2803163510"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,9]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> The goal of this study was to elucidate the pathophysiological features and clinical significance of the magnetic resonance imaging\u2014documented small intramedullary high signal intensity known as \u201csnake-eye appearance\u201d (SEA) in cases of compressive myelopathy such as cervical spondylosis or ossification of the posterior longitudinal ligament.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> One hundred forty-four patients with compression myelopathy who underwent surgery between 1998 and 2000 were selected. Intramedullary high signal intensity was found in 79 cases and was divided into two types, SEA and non-SEA (NSEA). The Japan Orthopaedic Association (JOA) scoring system was used for evaluation of pre- and postoperative neurological status. In nine cases of SEA autopsy was performed and specimens were histologically analyzed.<\/jats:p>\n<jats:p content-type=\"fine-print\">The improvement ratio determined by JOA score was 32.2 \u00b1 15.1% in SEA, 47.1 \u00b1 12.1% in NSEA, and 50 \u00b1 18.3% (p &lt; 0.01) in control cases in which high signal intesity was absent. There were significant differences among SEA, NSEA, and control groups. In a separate group of nine patients who died of unrelated causes, histological examination showed small cystic necrosis in the center of the central gray matter of the ventrolateral posterior column and significant neuronal loss in the flattened anterior horn.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> Snake-eye appearance was found to be a product of cystic necrosis resulting from mechanical compression and venous infarction. Destruction of the gray matter accompanying significant neuronal loss in the anterior horn suggested that SEA is an unfavorable prognostic factor for the recovery of upper-extremity motor weakness.<\/jats:p>","DOI":"10.3171\/spi.2003.99.2.0162","type":"journal-article","created":{"date-parts":[[2009,5,7]],"date-time":"2009-05-07T15:56:27Z","timestamp":1241711787000},"page":"162-168","source":"Crossref","is-referenced-by-count":62,"title":["Clinicopathological study of \u201csnake-eye appearance\u201d in compressive myelopathy of the cervical spinal cord"],"prefix":"10.3171","volume":"99","author":[{"given":"Junichi","family":"Mizuno","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Nakagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsushi","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshio","family":"Hashizume","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","first-page":"212","article-title":"Myelopathic cervical spondylotic lesions demonstrated by magnetic resonance imaging.","volume":"68","author":"Al-Mefty","year":"1988"},{"key":"b2","series-title":"Lancet","first-page":"55","article-title":"Degeneration of the spinal cord associated with cervical spondylosis.","volume":"2","author":"Bedford","year":"1952"},{"key":"b3","series-title":"Neuroradiology","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1007\/BF00588561","article-title":"Central spinal cord lesions in stenosis of the cervical canal.","volume":"32","author":"Faiss","year":"1990"},{"key":"b4","series-title":"J Bone Joint Surg Br","first-page":"393","article-title":"The prognosis of surgery for cervical compression myelopathy. 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Analysis of 29 surgical cases.","volume":"74","author":"Matsuda","year":"1991"},{"key":"b12","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1227\/00006123-199002000-00006","article-title":"Magnetic resonance imaging and cervical spondylotic myelopathy.","volume":"26","author":"Mehalic","year":"1990"},{"key":"b13","series-title":"Arch Neurol","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1001\/archneur.1978.00500250037008","article-title":"Cervical myelopathy due to ossification of the posterior longitudinal ligament: a clinicopathological study.","volume":"35","author":"Murakami","year":"1978"},{"key":"b14","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/00007632-198301000-00001","article-title":"Canal diameter, anteroposterior compression ratio, and spondylotic myelopathy of the cervical spine.","volume":"8","author":"Ogino","year":"1983"},{"key":"b15","series-title":"Spine","doi-asserted-by":"publisher","first-page":"2024","DOI":"10.1097\/00007632-199310001-00016","article-title":"Magnetic resonance imaging study on the results of surgery for cervical compression myelopathy.","volume":"18","author":"Okada","year":"1993"},{"key":"b16","series-title":"Spine","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1097\/00007632-197706000-00004","article-title":"Cervical myelopathy secondary to multiple spondylotic protrusions: a clinicopathological study.","volume":"2","author":"Ono","year":"1977"},{"key":"b17","series-title":"Spine","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1097\/00007632-198807000-00024","article-title":"Biomechanics of nonacute cervical cord trauma.","volume":"13","author":"Panjabi","year":"1988"},{"key":"b18","series-title":"J Comput Assist Tomogr","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1097\/00004728-198905000-00005","article-title":"MR imaging of compressive myelomalacia.","volume":"13","author":"Ramanauskas","year":"1989"},{"key":"b19","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/S0090-3019(99)00156-1","article-title":"Increased MRI signal intensity in association with myelopathy and cervical instability: case report and review of the literature.","volume":"53","author":"Ratliff","year":"2000"},{"key":"b20","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1148\/radiology.173.1.2781011","article-title":"Chronic cervical cord compression: clinical significance of increased signal intensity on MR images.","volume":"173","author":"Takahashi","year":"1989"},{"key":"b21","series-title":"Spine","doi-asserted-by":"publisher","first-page":"2226","DOI":"10.1097\/00007632-199510001-00009","article-title":"Intramedullary changes of the spinal cord in cervical spondylotic myelopathy.","volume":"20","author":"Wada","year":"1995"},{"key":"b22","series-title":"Spine","doi-asserted-by":"publisher","first-page":"S388","DOI":"10.1097\/00007632-199210001-00008","article-title":"Preoperative and postoperative magnetic resonance image evaluations of the spinal cord in cervical myelopathy.","volume":"17","author":"Yone","year":"1992"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/99\/2\/article-p162.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/99\/2\/article-p162.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/99\/2\/article-p162.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T20:32:40Z","timestamp":1681590760000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/99\/2\/article-p162.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,9]]},"references-count":22,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/spi.2003.99.2.0162","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2003,9]]}}}