Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
Department of Orthopedic Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea.
J Korean Med Sci. 2021 Feb 22;36(7):e48. doi: 10.3346/jkms.2021.36.e48.
Studies have reported on the usefulness of whole spine magnetic resonance imaging (MRI) in evaluating specific diseases such as spinal tuberculosis, spinal trauma, spondyloarthropathies, and multiple myeloma. In studies concerning degenerative spinal disease, sample sizes were small and some did not provide information on how symptomatic coexisting lesions were treated. We evaluated the types and prevalence of coexisting spine lesions found on whole spine T2 sagittal screening performed at the time of routine cervical and lumbar spine MRI and evaluated the efficacy of such screening in degenerative diseases of the cervical and lumbar spine.
We reviewed 1,757 and 2,266 consecutive cases where whole spine T2 sagittal screening had been performed with routine cervical and lumbar spine MRI, respectively, in patients with cervical and lumbar spinal degenerative diseases. Coexisting spine lesions were documented and statistical analysis was performed to investigate significant differences according to sex, age, and initial diagnosis. Electronic medical records were reviewed to determine whether additional interventions were necessary following such findings.
We reviewed 1,252 and 1,689 consecutive cases of routine cervical and lumbar spine MRI respectively, with whole spine T2 sagittal screening. Of the 1,252, 419 (33.5%) patients with cervical spinal degenerative disease had coexisting lesions in the thoracolumbar spine. Patients with ligament ossification disease of the cervical spine showed a higher prevalence of coexisting spine lesions. Sixty of the 419 (14.3%) patients with coexisting spine lesions warranted additional intervention or surgical treatment. Four hundred and eighty-one of 1,689 (28.5%) patients with lumbar degenerative disease had coexisting spine lesions in the cervicothoracic spine. Forty-eight of the 481 (10.0%) patients with coexisting spine lesions warranted additional intervention. In both patient groups, older patients showed a significantly higher prevalence of coexisting spine lesions than younger patients.
Considering the minimal extra time and cost in performing whole spine screening, its application to routine spine MRI can be considered in evaluating cervical and lumbar spinal degenerative diseases.
研究报告了全脊柱磁共振成像（MRI）在评估特定疾病方面的有用性，如脊柱结核、脊柱创伤、脊柱关节病和多发性骨髓瘤。在涉及退行性脊柱疾病的研究中，样本量较小，并且有些研究没有提供关于如何治疗同时存在的症状性病变的信息。我们评估了在常规颈椎和腰椎 MRI 时进行全脊柱 T2 矢状位筛查时发现的共存脊柱病变的类型和患病率，并评估了这种筛查在颈椎和腰椎退行性疾病中的效果。
我们回顾了分别在患有颈椎和腰椎退行性脊柱疾病的患者中进行常规颈椎和腰椎 MRI 时进行全脊柱 T2 矢状位筛查的 1757 例和 2266 例连续病例。记录共存脊柱病变，并进行统计学分析，以根据性别、年龄和初始诊断调查显著差异。审查电子病历以确定是否需要根据这些发现进行额外干预。
我们回顾了分别在常规颈椎和腰椎 MRI 时进行全脊柱 T2 矢状位筛查的 1252 例和 1689 例连续病例。在 1252 例患有颈椎退行性疾病的患者中，有 419 例（33.5%）存在胸腰椎脊柱的共存病变。患有颈椎韧带骨化病的患者显示出更高的共存脊柱病变患病率。在 419 例共存脊柱病变患者中，有 60 例需要额外干预或手术治疗。在 1689 例患有腰椎退行性疾病的患者中，有 481 例（28.5%）存在颈椎胸腰椎脊柱的共存病变。在 481 例共存脊柱病变患者中，有 48 例需要额外干预。在这两组患者中，年龄较大的患者比年龄较小的患者更明显地存在共存脊柱病变的患病率更高。
考虑到全脊柱筛查的额外时间和成本最小，在评估颈椎和腰椎退行性脊柱疾病时，可以考虑将其应用于常规脊柱 MRI。
