在接受法国门型椎板切开术治疗退行性颈椎病的患者中，脊髓损伤定量评估的短期预测潜力：利用术中超声数据进行的探索性研究的初步结果。

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.

机构信息

Department of Orthopedic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, P.R. China.

Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology /Orthopaedic Research Institute, Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan 2nd Road, Guangzhou, 510080, P.R. China.

出版信息

BMC Musculoskelet Disord. 2020 May 30;21(1):336. doi: 10.1186/s12891-020-03319-w.

DOI:10.1186/s12891-020-03319-w

PMID:32473626

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7261379/

Abstract

BACKGROUND

To study the correlation of neurological function in degenerative cervical myelopathy (DCM) patients with quantitative assessment of spinal cord compression and impairment by intraoperative ultrasound imaging (IOUSI).

METHODS

Twenty-three patients who underwent French-Door laminoplasty for multilevel DCM were followed for 6 months. Modified Japanese Orthopaedic Association (mJOA) score and cervical MRI were assessed before surgery and at postoperative 6 months. IOUS, used to guide decompression, were recorded. The anteroposterior diameter (APD) and the gray values of the IOUSI hyperechogenicity of the midsagittal IOUSI at the narrowest level and at the lesion-free level, and the APD and traverse diameter at the traverse maximum compression level of IOUSI were measured. Maximum spinal cord compression (MSCC), compression rate (CR), and IOUSI gray value ratio (R) were calculated. The appearance of preoperative T2W MRI increased signal intensity (ISI), and the signal change rate (SCR) on postoperative T2W MRI of 9 patients were also measured and calculated, and compared with that of IOUSI hyperechogenicity.

RESULTS

Average mJOA score increased significantly from 11.57 ± 2.67 before surgery to 15.39 ± 1.50 at 6 months after surgery, with an average recovery rate (RR) of 71.11 ± 22.81%. The difference between the appearance of preoperative T2W MRI ISI and IOUSI hyperechogenicity was not significant. Spearman correlation analysis found that the IOUSI R were negatively correlated with the RR of mJOA score with a coefficient of - 0.77, and the IOUSI R was not correlated with the postoperative MRI SCR.

CONCLUSIONS

In DCM patients, the gray values of IOUSI can be measured accurately. The IOUSI R correlated with postoperative neurological recovery significantly.

摘要

背景

研究术中超声成像（IOUSI）定量评估脊髓压迫和损伤与退行性颈椎脊髓病（DCM）患者神经功能的相关性。

方法

对 23 例行法式门椎板成形术治疗多节段 DCM 的患者进行了随访，随访时间为 6 个月。在术前和术后 6 个月分别评估改良日本矫形协会（mJOA）评分和颈椎 MRI。使用 IOUS 来指导减压，并记录 IOUSI。测量 IOUSI 在最狭窄水平和无病变水平的 midsagittal IOUSI 的前后直径（APD）和灰阶值，以及 IOUSI 在横切最大压迫水平的 APD 和横切直径。计算最大脊髓压迫（MSCC）、压迫率（CR）和 IOUSI 灰度比值（R）。测量 9 例患者术前 T2W MRI 上的信号强度增加（ISI）和术后 T2W MRI 的信号变化率（SCR），并与 IOUSI 高回声进行比较。

结果

mJOA 评分从术前的 11.57±2.67 显著增加到术后 6 个月的 15.39±1.50，平均恢复率（RR）为 71.11±22.81%。术前 T2W MRI ISI 的外观与 IOUSI 高回声之间的差异无统计学意义。Spearman 相关分析发现，IOUSI R 与 mJOA 评分的 RR 呈负相关，相关系数为-0.77，而 IOUSI R 与术后 MRI SCR 无关。