Hamdan Ali Rabee Kamel
Department of Neurosurgery, Faculty of Medicine, South Valley University, Qena, Egypt.
Asian J Neurosurg. 2019 Jan-Mar;14(1):106-110. doi: 10.4103/ajns.AJNS_262_17.
Cervical spondylotic myelopathy is a cervical cord compressive lesion that occurs as a result of the normal degenerative process which may cause magnetic resonance imaging (MRI) cord intensity changes that may worsen the clinical outcome even after successful anterior cervical decompression.
To assess the relation between MRI T2 Weighted images (T2 WI) hyperintense cord signal and clinical outcome after anterior cervical discectomy in patients with degenerative cervical disc herniation.
This is a retrospective observational study that was conducted on twenty-five patients with degenerative cervical disc prolapse associated with MRI T2WI hyperintense cord signal, at the Department of Neurosurgery, Qena University Hospital, South Valley University from August 2014 to December 2016. A complete clinical and radiological evaluation of the patients was done. Anterior cervical discectomy and fusion was done for all patients. Patients were clinically assessed preoperatively and postoperatively at 3, 6, and 12 months using Modified Japanese Orthopedic Association (MJOA) score. Radiographic assessment was done by preoperative and postoperative T2WI MRI. The statistical analysis was done using Statistical Package for the Social Sciences (SPSS) software (version 22.0).
There were 25 patients included in the study; 16 (64%) females and 9 (36%) males. The mean age was 46.89 ± 7.52 standard deviation (SD) years with range from 26 to 64 years, 3 (12%) patients had worsened in the form of postoperative motor power deterioration, and 14 (56%) patients has no improvement and remain as preoperative condition. The remaining 8 (32%) patients had a reported postoperative improvement of symptoms and signs according to MJOA score. The mean follow-up period (in months) was 11 ± 2.34 (SD).
The presence of T2W hyperintense signal on preoperative MRI predicts a poor surgical outcome in patients with cervical disc prolapse. The regression of T2W ISI postoperatively correlates with better functional outcomes.
脊髓型颈椎病是一种因正常退变过程导致的颈髓受压性病变，这可能会引起磁共振成像（MRI）脊髓信号强度改变，即便前路颈椎减压手术成功，这种改变也可能使临床预后恶化。
评估退行性颈椎间盘突出症患者前路颈椎间盘切除术后MRI T2加权像（T2 WI）脊髓高信号与临床预后之间的关系。
这是一项回顾性观察研究，于2014年8月至2016年12月在南谷大学基纳大学医院神经外科对25例伴有MRI T2WI脊髓高信号的退行性颈椎间盘突出症患者进行。对患者进行了全面的临床和影像学评估。所有患者均接受了前路颈椎间盘切除及融合术。术前及术后3个月、6个月和12个月使用改良日本骨科学会（MJOA）评分对患者进行临床评估。通过术前和术后T2WI MRI进行影像学评估。使用社会科学统计软件包（SPSS）软件（版本22.0）进行统计分析。
本研究共纳入25例患者；其中女性16例（64%），男性9例（36%）。平均年龄为46.89±7.52标准差（SD）岁，年龄范围为26至64岁，3例（12%）患者术后出现运动力量恶化，14例（56%）患者无改善，仍维持术前状态。其余8例（32%）患者根据MJOA评分报告术后症状和体征有所改善。平均随访期（月）为11±2.34（SD）。
术前MRI上T2加权高信号的存在预示着颈椎间盘突出症患者手术预后不良。术后T2WI信号强度指数的下降与更好的功能预后相关。
