Abstract: Intramedullary signal intensity (ISI) changes in morphology and extent of T2-weighted (T2W) in preopera⁃ tive cervical magnetic resonance (MR) images was thought to be indicative to the prognosis of cervical spondylotic myelopa⁃ thy (CSM) in recent years. However, the significance of ISI changes in predicting CSM prognosis remains controversial. Lack of satisfied evaluating approch of ISI on magnetic resonance imaging (MRI) is the main drawback. Identification of the type of T2WI ISI on preoperative MR imaging could give important information in predicting surgical outcome of patients with CSM. Currently, consensus is reached that preoperative multi-segmental T2WI ISI or sharp T2WI ISI indicate a worse prognosis for patients with CSM compared with regression of T2WI ISI. The literatures that link magnetic resonance imaging signal changes with prognosis of surgery to correct cervical spondylotic myelopathy are reviewed. The correlation of pathological changes and radiological performance of intramedullary signal intensity with prognosis of CSM are summarized to understand the significance of T2WI ISI on prognosis of surgical outcome.

Key words: cervical spondylosis, prognosis, cervical spondylotic myelopathy, intramedullary hyperintensity, T2-weighted image