Guangdong Provincial Biomedical Innovation Platform of Regeneration and Repair of Spinal Cord and Nerve Injury, Department of Orthopedic Surgery, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.
Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology /Orthopaedic Research Institute, Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Eur J Neurol. 2022 Jan;29(1):217-224. doi: 10.1111/ene.15109. Epub 2021 Sep 30.
The spinal cord central echo complex (SCCEC) is a special ultrasonography-based intramedullary structure, but its clinical significance in degenerative cervical myelopathy (DCM) is undefined. This study aimed to explore the potential of the SCCEC in predicting postoperative neurological recovery in DCM.
Thirty-two DCM patients who underwent intraoperative ultrasonography-guided French-door laminoplasty were prospectively enrolled. The modified Japanese Orthopaedic Association (mJOA) score was evaluated preoperatively and 12 months postoperatively. SCCEC width (SCCEC-W), and anteroposterior diameter (APD) and transverse diameter (TD) of the spinal cord were measured on transverse ultrasonographic images, while the tissue widths from anterior and posterior borders of the spinal cord to the SCCEC were measured on sagittal ultrasonographic images. The APD of the spinal cord and occupying rate of the spinal canal were measured on preoperative magnetic resonance imaging (MRI).
All patients achieved improvements in mJOA scores, with an average recovery rate (RR) of 68.69 ± 20.22%. Spearman correlation analysis revealed that SCCEC-W, and ratios between the SCCEC-W and APD/TD based on ultrasonography, correlated moderately with mJOA score RR, with coefficients of -0.527, -0.605 and -0.514, respectively. The ratio between SCCEC-W and ultrasonographic TD correlated moderately with preoperative APD of the spinal cord. The MRI measurements and ultrasonography-based tissue widths showed no significant correlation with mJOA score RR.
The SCCEC may have predictive potential as an intraoperative indicator of neurological recovery in treating DCM. SCCEC-W may be related to spinal cord compression in DCM.
脊髓中央回声复合体（SCCEC）是一种特殊的基于超声的髓内结构，但它在退行性颈脊髓病（DCM）中的临床意义尚未确定。本研究旨在探讨 SCCEC 在预测 DCM 术后神经功能恢复中的潜在价值。
前瞻性纳入 32 例接受术中超声引导下法式开门椎板成形术的 DCM 患者。术前和术后 12 个月采用改良日本骨科协会（mJOA）评分进行评估。在横切超声图像上测量 SCCEC 宽度（SCCEC-W）和脊髓的前后径（APD）及横径（TD），在矢状超声图像上测量脊髓前、后边界至 SCCEC 的组织宽度。术前磁共振成像（MRI）测量脊髓 APD 和椎管占据率。
所有患者 mJOA 评分均有改善，平均恢复率（RR）为 68.69±20.22%。Spearman 相关分析显示，SCCEC-W 以及基于超声的 SCCEC-W 与 APD/TD 的比值与 mJOA 评分 RR 中度相关，相关系数分别为-0.527、-0.605 和-0.514。SCCEC-W 与脊髓术前 APD 的比值与超声 TD 中度相关。MRI 测量值和基于超声的组织宽度与 mJOA 评分 RR 无显著相关性。
SCCEC 可能具有作为治疗 DCM 术中神经功能恢复的预测指标的潜力。SCCEC-W 可能与 DCM 中的脊髓受压有关。
