Nakagami W, Mimatsu K
Department of Orthopedic Surgery, Nagoya University, School of Medicine, Aichi, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1990 Sep;64(9):779-89.
This study was conducted to determine whether the cerebrospinal fluid pressure (CSFP) obtained by the lumbar puncture technique is capable of evaluating the pathological state of the cervical spinal canal stenosis (CSCS). A method was developed in which the CSFP was measured with a small piezoelectric semiconductor in combination with the lumbar puncture technique. The data thus obtained were quantitatively analysed using a personal computer. Using this method, we studied patients with cervical myelopathy due to vertebral canal stenosis. The CSFP wave form obtained by compression of the cervical region was converted into a regression curve using the computer. In order to estimate the vertebral canal stenosis ratio (spinal cord/dural tube) of patients with CSCS by CSFP, multiple regression analysis was performed to obtain a multiple regression with respective parameters as expository variables. Descending curve coefficients (CND, CFD and CED) were found to be useful as parameters estimating the state of CSCS by means of CSFP analysis. On the basis of these parameters, CND, the coefficient of a descending curve obtained at the neutral cervical position, and CED, the coefficient of a descending curve obtained at the extended position, patients with CSCS were able to distinguish from normal subjects. The multiple regression equation (Y = 73.2-3890 CNA-4740 CND + 3620 CFD-10470 CEA-802 CED-0.119 NPP) was statistically significant at P = 0.01, therefore, useful in estimating the vertebral canal stenosis ratio. On the contrary, the values calculated from the multiple regression equation were not well correlated with either the JOA (Japanese Orthopedic Association) scores evaluated in accordance with the JOA Criteria or with the spinal compression ratio (anterior-to-posterior diameter/right-to-left diameter).
本研究旨在确定通过腰椎穿刺技术获得的脑脊液压力(CSFP)是否能够评估颈椎管狭窄(CSCS)的病理状态。开发了一种方法,其中使用小型压电半导体结合腰椎穿刺技术测量CSFP。使用个人计算机对由此获得的数据进行定量分析。使用这种方法,我们研究了因椎管狭窄导致的颈椎病患者。通过计算机将颈椎区域受压获得的CSFP波形转换为回归曲线。为了通过CSFP估计CSCS患者的椎管狭窄率(脊髓/硬脊膜管),进行了多元回归分析,以获得以各个参数作为解释变量的多元回归。发现下降曲线系数(CND、CFD和CED)作为通过CSFP分析估计CSCS状态的参数是有用的。基于这些参数,即颈椎中立位获得的下降曲线系数CND和伸展位获得的下降曲线系数CED,能够将CSCS患者与正常受试者区分开来。多元回归方程(Y = 73.2 - 3890 CNA - 4740 CND + 3620 CFD - 10470 CEA - 802 CED - 0.119 NPP)在P = 0.01时具有统计学意义,因此可用于估计椎管狭窄率。相反,从多元回归方程计算出的值与根据日本矫形外科学会(JOA)标准评估的JOA评分或脊髓压迫率(前后径/左右径)均无良好相关性。