Abstract
Spinal cord compression may induce cortical reorganization. This study follows a patient with cervical spondylotic myelopathy to investigate changes in cortical activation before and after decompressive surgery. The relationship with functional recovery is also described. A 37-year-old right-hand-dominant man presented a 1-month history of rapidly worsening right-hand clumsiness, right-sided hemiparesis, and gait difficulties. Physical examination confirmed severe right-sided weakness, impaired dexterity, hyperreflexia, and wide-based gait. The patient underwent blood oxygenation level-dependent functional magnetic resonance imaging at 4 T. Images were obtained before and 6 months after an anterior cervical discectomy with insertion of an artificial disk. Blood oxygenation level-dependent functional magnetic resonance imaging was used to detect changes in cortical activation over time during a finger-tapping (motor) paradigm. Improvement in clinical function was recorded with validated clinical tools, including the Japanese Orthopedic Association scale for cervical spondylotic myelopathy, the Nurick neurological function score, and the Neck Disability Index, along with clinical examination. After decompressive cervical spine su...Continue Reading
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