Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Department of Orthopedic Surgery, Chubu Rosai Hospital, Japan Labor Health and Welfare Organization, Nagoya, Japan.
Spine (Phila Pa 1976). 2018 Mar 15;43(6):420-426. doi: 10.1097/BRS.0000000000002328.
A prospective imaging study.
The study investigated whether the classification of increased signal intensity (ISI) using magnetic resonance imaging (MRI) reflects the severity of symptoms in patients with cervical spondylotic myelopathy (CSM).
Although the ISI on MRI in patients with CSM is observed, the degree of ISI has not been examined. The association between ISI and the surgical outcomes in cervical myelopathy remains controversial.
A total of 505 consecutive patients with CSM (311 males; 194 females) were enrolled. The mean age was 66.6 years (range, 41-91 yrs), with an average postoperative follow-up period of 26.5 ± 12.5 months. The ISI was classified into three groups based on sagittal T2-weighted MRI as follows: Grade 0, none; Grade 1, light (obscure); and Grade 2, intense (bright). Pre- and postoperative neurological status was evaluated using the Japanese Orthopedic Association scoring system for cervical myelopathy (JOA score) and quantifiable tests, including the 10-s grip and release test (10-s G&R test) and the 10-s step test.
The preoperative MRI showed 168 patients in Grade 0, 169 patients in Grade 1, and 168 in Grade 2, with no age differences among three groups. Grade 2 patients had a longer duration of symptom compared with the other grades. Grade 0 patients had a better postoperative JOA score and recovery rate compared with the other grades. The preoperative and postoperative scores in the G&R test and steps were better in the Grade 0 patients compared with the other grades. Grade 1 and 2 patients had similar outcomes and recovery rates.
ISI on MRI in patients with CSM was prospectively classified into three grades. The ISI grading was not associated with the preoperative severity of myelopathy and outcomes.
一项前瞻性影像学研究。
本研究旨在探讨磁共振成像（MRI）上信号强度增加（ISI）的分类是否反映了颈椎病脊髓病（CSM）患者症状的严重程度。
尽管 CSM 患者的 MRI 上存在 ISI，但尚未检查 ISI 的程度。ISI 与颈脊髓病手术结果之间的关联仍存在争议。
共纳入 505 例连续的 CSM 患者（311 例男性；194 例女性）。平均年龄为 66.6 岁（范围，41-91 岁），平均术后随访时间为 26.5±12.5 个月。根据矢状 T2 加权 MRI 将 ISI 分为三组：0 级，无；1 级，轻度（模糊）；2 级，重度（明亮）。使用日本矫形协会颈椎病评分系统（JOA 评分）和可量化测试，包括 10 秒握力和释放测试（10-s G&R 测试）和 10 秒步测试，对术前和术后的神经功能进行评估。
术前 MRI 显示 0 级 168 例，1 级 169 例，2 级 168 例，三组间年龄无差异。2 级患者的症状持续时间较其他等级长。0 级患者术后 JOA 评分和恢复率优于其他等级。0 级患者的 G&R 测试和步骤的术前和术后评分均优于其他等级。1 级和 2 级患者的结果和恢复率相似。
CSM 患者的 MRI 上的 ISI 被前瞻性地分为三级。ISI 分级与术前脊髓病的严重程度和结果无关。
2 级。
