The authors of this study wanted to see how compression affected human Spinal Cord Elasticity (SCE) in vivo. The authors used intraoperative shear wave elastography to assess SCE in a prospective study (SWE). Between June 2018 and June 2019, all patients who had spinal cord (SC) decompression (laminectomy or corpectomy) were included. At least three SWE measurements of the SC and its coverings were done after surgical exposure of the patient’s dura mater. Intraoperative neurological monitoring was done using motor and somatosensory evoked potentials. Patients with appropriate decompression (the decompressed SC group [DCG]) following bone removal (laminectomy or corpectomy) were split into two groups: those with remaining compression (e.g., compressing tumor or instability) and those with remaining reduction (the remaining SC group [RCG]) (the compressed SC group [COG]).

About 25 patients were enrolled in the study. Degenerative disorders (10 instances) were the most common, followed by malignancies (6 cases), with compression found at the cervical (n = 14), thoracic (n = 9), and conus medullaris (n = 2) levels. The decompressed SC in DCG (median 9.35, IQR 6.95–11.22 kPa, p < 0.001) had considerably higher elasticity values, i.e., stiffness (median 93.84, IQR 75.27–121.75 kPa). Similarly, the crushed dura mater in the COG was substantially stiffer (mean ± SD 121.83 ± 70.63 kPa) than that in the DCG. After SC decompression in COG, SCE levels were significantly reduced (p = 0.006; multiple comparisons corrected). Intraoperative monitoring revealed no deterioration from the baseline condition.  According to the authors, the current work is the first to show quantitatively enhanced stiffness (i.e., elasticity value) of the human SC and dura mater in response to external compression in vivo. SCE appears to be a dynamic phenomenon that decreases with decompression. Furthermore, utilizing the SWE approach to assess human SCE is possible and safe. Future studies aimed at further defining SCE could be useful in making an early and precise diagnosis of a compressed SC.

 

Reference:thejns.org/spine/view/journals/j-neurosurg-spine/35/6/article-p807.xml