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Abstract

Quantitative neuroimaging techniques provide reproducible maps of “quantitative” values proportional to tissue microstructure, such as myelin, axonal density, tissue vascularization, iron deposition, and metabolic profiling. Applied to degenerative cervical myelopathy (DCM) patients, this approach has revealed secondary neurodegenerative changes, such as atrophy, demyelination, and axonal degeneration, which not only affect the maximal site of compression but also below and above the site of compression. Remote degenerative changes have been even reported in the brains of DCM patients. To detect tissue at risk and prevent irreversible tissue damage in the early stages of DCM, there is a pressing need to determine tissue integrity and the underlying pathophysiology across the neuroaxis. Thus qMRI measures can make a major contribution to the diagnostic workup of DCM and as a valuable outcome measure in preoperative neurologic status. This chapter briefly reviews conventional magnetic resonance imaging and qMRI techniques most commonly applied to the spinal cord and then focuses on reviewing the literature that reports on DCM patients using advanced MRI approaches. The clinical and pathophysiological significance of the results of these studies will be discussed and future directions of research will be proposed.