Wada E, Yonenobu K, Suzuki S, Kanazawa A, Ochi T
Department of Orthopaedic Surgery, Osaka University Medical School, Suita, Japan.
Spine (Phila Pa 1976). 1999 Mar 1;24(5):455-61; discussion 462. doi: 10.1097/00007632-199903010-00009.
A retrospective study evaluating magnetic resonance imaging, computed tomographic myelography, and clinical parameters in patients with cervical spondylotic myelopathy.
To investigate whether magnetic resonance imaging can predict the surgical outcome in patients with cervical spondylotic myelopathy.
No previous studies have established whether areas of high signal intensity in T2-weighted magnetic resonance images can be a predictor of surgical outcomes.
Fifty patients with cervical spondylotic myelopathy were examined by magnetic resonance imaging and computed tomographic myelography before surgery and by delayed computed tomographic myelography after surgery. The correlation between the recovery rate and the clinical and imaging parameters was analyzed.
The best prognostic factor was the transverse area of the spinal cord at maximum compression (correlation coefficient, R = 0.58). The presence of high signal intensity areas on T2-weighted magnetic resonance images correlated poorly with the recovery rate (R = -0.29). However, patients with multisegmental areas of high signal intensity on T2-weighted magnetic resonance images tended to have poor surgical results associated with muscle atrophy in the upper extremities. Postoperative delayed computed tomographic myelography showed that multisegmental areas of high signal intensity on T2-weighted magnetic resonance images probably represent cavitation in the central spinal cord.
Patients with multisegmental areas of high signal intensity on T2-weighted magnetic resonance images tended to have poorer surgical results. However, the transverse area of the spinal cord at the level of maximum compression was a better prognostic indicator.
一项回顾性研究，评估脊髓型颈椎病患者的磁共振成像、计算机断层脊髓造影及临床参数。
探讨磁共振成像能否预测脊髓型颈椎病患者的手术效果。
既往尚无研究确定T2加权磁共振图像上的高信号强度区域是否可作为手术结果的预测指标。
对50例脊髓型颈椎病患者在手术前进行磁共振成像和计算机断层脊髓造影检查，并在术后进行延迟计算机断层脊髓造影检查。分析恢复率与临床及影像参数之间的相关性。
最佳预后因素是脊髓最大受压处的横截面积（相关系数，R = 0.58）。T2加权磁共振图像上高信号强度区域的存在与恢复率的相关性较差（R = -0.29）。然而，T2加权磁共振图像上有多节段高信号强度区域的患者手术效果往往较差，且伴有上肢肌肉萎缩。术后延迟计算机断层脊髓造影显示，T2加权磁共振图像上的多节段高信号强度区域可能代表脊髓中央空洞形成。
T2加权磁共振图像上有多节段高信号强度区域的患者手术效果往往较差。然而，脊髓最大受压水平处的横截面积是更好的预后指标。
