Department of Spine Surgery, Changhai Hospital, The Second Military Medical University, 168 Changhai Road, Shanghai 200433, China.
J Clin Neurosci. 2011 Dec;18(12):1592-5. doi: 10.1016/j.jocn.2011.04.019. Epub 2011 Oct 21.
We used PubMed, Medline, and EMBASE to conduct a meta-analysis to determine the significance of high signal intensity on T2-weighted MRI for predicting postoperative prognosis in patients with cervical spondylotic myelopathy (CSM). Although patients with CSM with high signal intensity on T2-weighted MRI usually had a poor prognosis even after undergoing surgery, some researchers have argued recently that high-intensity signals are not associated with postoperative prognosis. Data consistent with the inclusion criteria of this study were cited for meta-analysis using Review Manager 5 Software. The postoperative recovery ratio specified by the Japanese Orthopedic Association (JOA) was assessed using the weighted mean difference (WMD) method. Five articles (one prospective; four retrospective) involving 309 patients with CSM were included. The aggregate WMD with regard to the postoperative JOA recovery ratio between the T2-weighted high signal intensity positive (+) group and the T2-weighted high signal intensity negative (-) group was -6.56, and the 95% confidence interval (CI) was -12.15 to -0.97 (p=0.02). Thus, we concluded that in patients with CSM, the postoperative JOA recovery ratio in the T2-weighted (+) group was lower than that in the T2-weighted (-) group.
我们使用 PubMed、Medline 和 EMBASE 进行了荟萃分析，以确定 T2 加权 MRI 上的高信号强度对预测颈椎脊髓病（CSM）患者术后预后的意义。尽管 T2 加权 MRI 上有高信号强度的 CSM 患者即使手术后预后通常也较差，但最近一些研究人员认为高强度信号与术后预后无关。使用 Review Manager 5 软件对符合本研究纳入标准的数据进行了荟萃分析。使用加权均数差（WMD）方法评估日本矫形协会（JOA）规定的术后恢复率。纳入了 5 篇文章（1 篇前瞻性；4 篇回顾性），共 309 例 CSM 患者。T2 加权高信号强度阳性（+）组和 T2 加权高信号强度阴性（-）组之间的术后 JOA 恢复率的总体 WMD 为-6.56，95%置信区间（CI）为-12.15 至-0.97（p=0.02）。因此，我们得出结论，在 CSM 患者中，T2 加权（+）组的术后 JOA 恢复率低于 T2 加权（-）组。
