Coronado Rogelio, Hudson Beverly, Sheets Charles, Roman Matthew, Isaacs Robert, Mathers Jessie, Cook Chad
J Man Manip Ther. 2009;17(3):148-53. doi: 10.1179/jmt.2009.17.3.148.
Information gathered from the patient history, physical examination, and advanced testing augments the decision-making process and is proposed to improve the probability of diagnostic and prognostic accuracy. However, these findings may provide inconsistent results and can lead to errors in decision-making. The purpose of this study was to examine the relationship between common clinical complaints and specific findings on magnetic resonance imaging (MRI) in patients with chronic neck dysfunction. Forty-five English-speaking participants (25 female), with mean age of 52 (SD = 13.4), were evaluated by a neurosurgeon for complaints of symptoms related to the cervical spine. All participants answered a subjective questionnaire and received an MRI of the cervical spine. Cramer's V nominal correlation was performed to explore the relationship between the targeted variables. The correlation matrix calculations captured three significant findings. Evidence of spinal cord compression was significantly correlated to 1) anteroposterior canal diameter of less than or equal to 9 mm (r = .31; p<0.05) and 2) diminished subarachnoid fluid around the cord (r = .48; p<0.01). Report of loss of dexterity was significantly correlated with 3) report of lower extremity clumsiness (r = .33; p<0.05). In this study, no definitive relationships were found between the clinical complaints of neck pain, hand function, or clumsiness and specific MRI findings of spinal cord compression. Further research is needed to investigate the diagnostic utility of subjective complaints and their association with advanced testing.
从患者病史、体格检查及高级检测中收集到的信息有助于决策过程,旨在提高诊断和预后准确性的概率。然而,这些结果可能并不一致,且可能导致决策失误。本研究的目的是探讨慢性颈部功能障碍患者常见临床症状与磁共振成像(MRI)特定表现之间的关系。45名讲英语的参与者(25名女性),平均年龄52岁(标准差 = 13.4),由一名神经外科医生对其颈椎相关症状进行评估。所有参与者均回答了一份主观问卷,并接受了颈椎MRI检查。采用克莱默V名义相关性分析来探究目标变量之间的关系。相关性矩阵计算得出了三个显著结果。脊髓受压的证据与以下因素显著相关:1)前后径小于或等于9毫米(r = 0.31;p<0.05)以及2)脊髓周围蛛网膜下腔液减少(r = 0.48;p<0.01)。灵活性丧失的报告与3)下肢笨拙的报告显著相关(r = 0.33;p<0.05)。在本研究中,未发现颈部疼痛、手部功能或笨拙等临床症状与脊髓受压的特定MRI表现之间存在明确关系。需要进一步研究来调查主观症状的诊断效用及其与高级检测的关联。