Stino Amro Maher, LoRusso Samantha J
Continuum (Minneap Minn). 2018 Apr;24(2, Spinal Cord Disorders):567-583. doi: 10.1212/CON.0000000000000594.
The article discusses the current diagnostic and therapeutic approach to myelopathies occurring as a consequence of structural cervical and thoracic spine disease.
The exact pathophysiologic basis of cervical spondylotic myelopathy remains somewhat elusive. Diffusion-tensor imaging has emerged as a useful imaging modality that correlates more closely with clinical severity than standard MRI. Baseline disease severity, symptom duration, age, presence of impaired gait, and smoking status are significant factors related to surgical outcomes.
Advances in neuroimaging and the development of evidence-based algorithmic approaches to surgical intervention will likely further improve the outcomes of patients with spinal cord dysfunction from structural cervical and thoracic disease.
本文探讨了由颈椎和胸椎结构疾病引起的脊髓病的当前诊断和治疗方法。
脊髓型颈椎病的确切病理生理基础仍有些难以捉摸。扩散张量成像已成为一种有用的成像方式,与标准MRI相比,它与临床严重程度的相关性更强。基线疾病严重程度、症状持续时间、年龄、步态障碍的存在以及吸烟状况是与手术结果相关的重要因素。
神经影像学的进展以及基于证据的手术干预算法方法的发展可能会进一步改善因颈椎和胸椎结构疾病导致脊髓功能障碍患者的治疗效果。