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颈椎板成形术后脊髓的经皮超声评估:时间依赖性变化。

Percutaneous ultrasonographic evaluation of the spinal cord after cervical laminoplasty: time-dependent changes.

机构信息

Department of Orthopedic Surgery, Osaka Medical College, 2-7, Daigakumachi, Takatsuki-shi, Osaka, 569-8686, Japan.

出版信息

Eur Spine J. 2018 Nov;27(11):2763-2771. doi: 10.1007/s00586-018-5752-4. Epub 2018 Sep 7.


DOI:10.1007/s00586-018-5752-4
PMID:30194532
Abstract

PURPOSE: The first purpose of this study is to confirm whether the spinal cord and the surrounding tissues can be visualized clearly after laminoplasty using percutaneous ultrasonography. And second purpose is to evaluate the changes in the status of the spinal cord over time. METHODS: Fifty patients who underwent cervical laminoplasty with suture anchors were evaluated using intraoperative ultrasonography and postoperative (1 week, 2 weeks, 3 months, 6 months, and 1 year) percutaneous ultrasonography. We classified the decompression status of the spinal cord into three grades and the pattern of the spinal cord pulsation into six categories. Clinical outcomes were evaluated using the Japanese Orthopaedic Association Score for cervical myelopathy, and the recovery rate was calculated. RESULTS: In all cases and all periods, we could observe the status of the spinal cord using percutaneous ultrasonography after cervical laminoplasty. The decompression status of the spinal cord improved until 3 months postoperatively, and the clinical outcomes improved up to 6 months postoperatively. Although the pulsation pattern of the spinal cord varied in each individual and in each period, spinal pulsation itself was observed in all cases and all periods, except one, when an epidural hematoma caused quadriplegia and a revision surgery was needed. Decompression status and pulsation pattern of the spinal cord were not associated with clinical outcomes as far as pulsation was observed. CONCLUSIONS: Percutaneous ultrasonography was very useful method to evaluate the postoperative status of the spinal cord, particularly in the diagnosis of the postoperative epidural hematoma. These slides can be retrieved under Electronic Supplementary Material.

摘要

目的:本研究的首要目的是确认经皮超声检查能否清晰显示椎板切开术后脊髓及周围组织。其次目的是评估脊髓状况随时间的变化。

方法:对 50 例行缝合锚钉颈椎椎板切开术的患者进行术中超声和术后(1 周、2 周、3 个月、6 个月和 1 年)经皮超声检查。我们将脊髓减压状态分为 3 个等级,脊髓搏动模式分为 6 个类别。使用日本骨科协会颈椎脊髓病评分评估临床结果,并计算恢复率。

结果:在所有病例和所有时期,我们都可以通过经皮超声观察颈椎椎板切开术后脊髓的状况。脊髓减压状态在术后 3 个月内改善,临床结果在术后 6 个月内改善。虽然脊髓搏动模式在每个个体和每个时期都有所不同,但除了一例因硬膜外血肿导致四肢瘫痪需要再次手术的病例外,所有病例和所有时期都可以观察到脊髓搏动。只要观察到搏动,脊髓减压状态和搏动模式与临床结果无关。

结论:经皮超声是评估脊髓术后状况的非常有用的方法,特别是在诊断术后硬膜外血肿方面。这些幻灯片可以在电子补充材料中检索到。

相似文献

[1]
Percutaneous ultrasonographic evaluation of the spinal cord after cervical laminoplasty: time-dependent changes.

Eur Spine J. 2018-9-7

[2]
Usefulness of Percutaneous Ultrasonography for Deciding the Need of Surgical Evacuation of Epidural Hematoma After Cervical Double-door Laminoplasty.

Clin Spine Surg. 2022-2-1

[3]
Decompression status of the spinal cord after cervical laminoplasty in various body positions and neck postures observed using percutaneous ultrasonography: Relationship with neurological recovery.

J Orthop Sci. 2022-7

[4]
Spinal cord morphology and dynamics during cervical laminoplasty: evaluation with intraoperative sonography.

Spine (Phila Pa 1976). 2007-10-1

[5]
Percutaneous ultrasonographic evaluation of the spinal cord after cervical laminoplasty.

Spine (Phila Pa 1976). 2014-4-1

[6]
Prediction of clinical results of laminoplasty for cervical myelopathy focusing on spinal cord motion in intraoperative ultrasonography and postoperative magnetic resonance imaging.

Spine (Phila Pa 1976). 2009-11-15

[7]
Effect and Prognostic Factors of Laminoplasty for Cervical Myelopathy With an Occupying Ratio Greater Than 50%.

Spine (Phila Pa 1976). 2016-3

[8]
Short-term predictive potential of quantitative assessment of spinal cord impairment in patients undergoing French-door Laminoplasty for degenerative cervical myelopathy: preliminary results of an exploratory study exploiting intraoperative ultrasound data.

BMC Musculoskelet Disord. 2020-5-30

[9]
Increased blood flow of spinal cord lesion after decompression improves neurological recovery of degenerative cervical myelopathy: an intraoperative ultrasonography-based prospective cohort study.

Int J Surg. 2023-5-1

[10]
Ultrasonographic quantification of spinal cord and dural pulsations during cervical laminoplasty in patients with compressive myelopathy.

Eur Spine J. 2012-7-21

引用本文的文献

[1]
Future perspectives after the guidelines of degenerative cervical myelopathy: A narrative review.

J Clin Orthop Trauma. 2025-6-14

[2]
Evolution of Spinal Cord Swelling in Acute Traumatic Spinal Cord Injury.

Neurotrauma Rep. 2025-2-12

[3]
Preliminarily exploring the intraoperative ultrasonography characteristics of patients with degenerative cervical myelopathy.

BMC Musculoskelet Disord. 2024-7-12

[4]
Intraoperative and Postoperative Ultrasonographic Spinal Cord Evaluation of Cervical Double-Door Laminoplasty.

Cureus. 2024-5-29

[5]
Alterations of gait kinematics depend on the deformity type in the setting of adult spinal deformity.

Eur Spine J. 2022-11

本文引用的文献

[1]
Extraordinary positional cervical spinal cord compression in extension position as a rare cause of postoperative progressive myelopathy after cervical posterior laminoplasty detected using the extension/flexion positional CT myelography: one case after laminectomy following failure of a single-door laminoplasty/one case after double-door laminoplasty without interlaminar spacers.

Eur Spine J. 2017-5

[2]
Double-door cervical laminoplasty with suture anchors: evaluation of the clinical performance of the constructs.

Eur Spine J. 2017-4

[3]
Percutaneous ultrasonographic evaluation of the spinal cord after cervical laminoplasty.

Spine (Phila Pa 1976). 2014-4-1

[4]
Intraoperative Neural Mobility and Postoperative Neurological Recovery in Anterior Cervical Decompression Surgery: Evaluation With Intraoperative Sonography.

Clin Spine Surg. 2016-6

[5]
Ultrasonographic quantification of spinal cord and dural pulsations during cervical laminoplasty in patients with compressive myelopathy.

Eur Spine J. 2012-7-21

[6]
Incidence of postoperative symptomatic epidural hematoma in spinal decompression surgery.

J Neurosurg Spine. 2011-5-6

[7]
Intraoperative ultrasonographic evaluation of posterior decompression via laminoplasty in patients with cervical ossification of the posterior longitudinal ligament: correlation with 2-year follow-up results.

J Neurosurg Spine. 2010-7

[8]
Prediction of clinical results of laminoplasty for cervical myelopathy focusing on spinal cord motion in intraoperative ultrasonography and postoperative magnetic resonance imaging.

Spine (Phila Pa 1976). 2009-11-15

[9]
Dynamic evaluation of the spinal cord in patients with cervical spondylotic myelopathy using a kinematic magnetic resonance imaging technique.

J Spinal Disord Tech. 2009-2

[10]
Double-door cervical laminoplasty with the use of suture anchors: technical note.

J Spinal Disord Tech. 2008-12

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