DIFFUSION TENSOR TRACTOGRAPHY (DTT) ? AN OBJECTIVE METHOD OF DETERMINING CLINICALLY-RELEVANT, COMPRESSIVE, SPINAL CORD MYELOPATHY

We commonly come across cases of compressive spinal cord myelopathy (CSCM) due to variety of clinical conditions in our day-to-day radiological practice. Magnetic resonance imaging (MRI) has long been considered as the gold-standard imaging tool for evaluation of such cases. These cases reveal signs of spinal cord compression with or without alteration in spinal cord parenchymal signal alteration. Though, diffusion tensor imaging especially fiber-tracking or tractography has been described to be superior to routine MRI in predicting prognosis and urgency of decompression yet fewer studies have been conducted to demonstrate it especially in developing world. Hence, this study aims to evaluate diffusion tensor tractography (DTT) as an advanced dimension of MRI in patients with CSCM in predicting necessity of decompression management, predicting prognosis and evaluating post-decompression outcome objectively in simplified manner.