Degenerative cervical myelopathy (DCM) is one of the most common forms of spinal cord dysfunction. Predicting functional recovery after surgery remains elusive. The extent of cortical activation in the primary motor cortex was assessed using fMRI when DCM patients performed a controlled finger-tapping task. Spine compression severity was quantified using T2-weighted imaging. Patients with severe spine compression showed larger activation volumes. Recruitment of neurons to compensate for functional deficits may explain these activation changes. Hypoxia at the spine compression site may drive this cortical plasticity. Future studies should measure hypoxia and explore prognostic determinants.
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