Chikhale Chaitanya Baban, Khurjekar Ketan Shripad, Shyam Ashok Kumar, Sancheti Parag Kantilal
Department of Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, India.
Asian Spine J. 2017 Apr;11(2):174-180. doi: 10.4184/asj.2017.11.2.174. Epub 2017 Apr 12.
This was a single surgeon, single center-based retrospective study with prospective data collection.
To assess the correlation between T2-weighted magnetic resonance imaging (MRI) signal intensity (SI) changes and factors such as age, duration of symptoms, baseline modified Japanese Orthopedic Association (mJOA) score and to determine its prognostic value in predicting recovery after surgery.
Whether intramedullary cord T2-weighted MRI SI changes can predict operative outcomes of cervical myeloradiculopathy remains debatable, with only a few prospective studies analyzing the same.
Forty-six consecutive patients who underwent cervical myeloradiculopathy were included and were followed up for an average of 1 year. Preoperative T2-weighted MRI SI grading was performed for all patients. The correlation between MRI SI changes and age, duration of symptoms, preoperative mJOA score, and mJOA score at 1-year follow-up were analyzed.
Fifteen patients had single-level (21.73%) or double-level (10.86%) prolapsed discs; 54.34% had degenerative cervical spondylosis with canal stenosis or multilevel disc prolapse and 13.07% had ossified posterior longitudinal ligaments. The mean age was 56.17±9.53 years (range, 35-81 years). The mean baseline mJOA score was 10.83±2.58 (range, 6-16), which postoperatively improved to 13.59±2.28 (range, 8-17; <0.001). There was a statistically significant correlation between mJOA score at 1 year and MRI T2 SI grading (=0.017).
Patients with longer symptom durations had high grades of intramedullary cord T2-weighted MRI SI changes. Age and preoperative neurological status were not significantly correlated with the existence of intramedullary cord SI changes. However, patients without or with mild and diffuse intramedullary cord T2-weighted MRI SI changes had better postoperative neurological recovery than those with sharp and focal SI changes.
这是一项基于单中心、由单一外科医生进行的回顾性研究，并进行前瞻性数据收集。
评估T2加权磁共振成像（MRI）信号强度（SI）变化与年龄、症状持续时间、基线改良日本骨科协会（mJOA）评分等因素之间的相关性，并确定其在预测手术后恢复情况方面的预后价值。
脊髓内T2加权MRI SI变化能否预测颈椎病性脊髓病的手术结果仍存在争议，仅有少数前瞻性研究对此进行分析。
纳入46例连续接受颈椎病性脊髓病治疗的患者，平均随访1年。对所有患者进行术前T2加权MRI SI分级。分析MRI SI变化与年龄、症状持续时间、术前mJOA评分以及1年随访时mJOA评分之间的相关性。
15例患者有单节段（21.73%）或双节段（10.86%）椎间盘突出；54.34%有退行性颈椎管狭窄或多节段椎间盘突出的颈椎病，13.07%有后纵韧带骨化。平均年龄为56.17±9.53岁（范围35 - 81岁）。平均基线mJOA评分为10.83±2.58（范围6 - 16），术后改善至13.59±2.28（范围8 - 17；P<0.001）。1年时的mJOA评分与MRI T2 SI分级之间存在统计学显著相关性（P = 0.017）。
症状持续时间较长的患者脊髓内T2加权MRI SI变化分级较高。年龄和术前神经功能状态与脊髓内SI变化的存在无显著相关性。然而，脊髓内T2加权MRI SI变化无或轻度及弥漫性改变的患者术后神经功能恢复优于SI变化尖锐且局限的患者。
