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超声检查在评估退变性颈椎病神经根状况方面的额外益处。

Additional benefit of ultrasonography to evaluate nerve root condition of degenerative cervical spine disease.

作者信息

Kozuki Hiroki, Tadokoro Nobuaki, Aoyama Naoki, Kiyasu Katsuhito, Takemasa Ryuichi, Ikeuchi Masahiko

机构信息

Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan.

出版信息

Spinal Cord. 2023 Jan;61(1):69-75. doi: 10.1038/s41393-022-00865-z. Epub 2022 Oct 31.

Abstract

STUDY DESIGN

A cross-sectional explanatory study.

OBJECTIVES

To clarify the nerve root condition and the association between nerve root cross-sectional area (CA) on ultrasonography (US) and other examinations such as MRI or compound muscle action potentials (CMAPs) in degenerative cervical spine diseases.

SETTING

A university hospital in Japan.

METHODS

Fifty-one patients diagnosed with proximal cervical spondylotic amyotrophy (CSA) (13 patients), cervical radiculopathy of C5 or C6 nerve root (CR) (26 patients), or cervical spondylotic myelopathy (CSM) (12 patients), and twenty-nine healthy volunteers were included in this study. Neurological findings, US findings and CMAPs of deltoid and biceps muscles of all participants were evaluated. In addition, CSA, CR, and CSM patients underwent MRI.

RESULTS

A significant correlation was not observed between CA and CMAP amplitude or foraminal diameter on MRI (P > 0.05). In the US examination, the C6 CA of the affected side of the CR group was significantly larger than that of both the normal side and the other groups (P < 0.001). The C5 CA of the affected side of the CSA group clearly showed a bimodal distribution: enlarged and small CA groups. In the CMAP findings, CSA cases respectively showed the lower amplitude of deltoid and bicep CMAPs on both the normal and the affected side (P ≦ 0.01). CSM and healthy volunteers were nearly identical in CA and CMAPs.

CONCLUSION

Utilizing US in addition to NCS and MRI can contribute towards an evaluation of the nerve root condition of degenerative cervical spine disease.

SPONSORSHIP

no sponsorship.

摘要

研究设计

横断面解释性研究。

目的

阐明退变性颈椎病患者神经根状况以及超声(US)测量的神经根横截面积(CA)与其他检查(如MRI或复合肌肉动作电位(CMAP))之间的关联。

地点

日本一家大学医院。

方法

本研究纳入了51例被诊断为近端型颈椎病性肌萎缩(CSA)(13例)、C5或C6神经根型颈椎病(CR)(26例)或脊髓型颈椎病(CSM)(12例)的患者以及29名健康志愿者。评估了所有参与者的神经学检查结果、US检查结果以及三角肌和肱二头肌的CMAP。此外,CSA、CR和CSM患者接受了MRI检查。

结果

未观察到CA与MRI上的CMAP波幅或椎间孔直径之间存在显著相关性(P>0.05)。在US检查中,CR组患侧的C6 CA明显大于正常侧和其他组(P<0.001)。CSA组患侧的C5 CA明显呈现双峰分布:CA增大组和CA减小组。在CMAP检查结果中,CSA病例在正常侧和患侧的三角肌和肱二头肌CMAP波幅均较低(P≤0.01)。CSM患者和健康志愿者在CA和CMAP方面几乎相同。

结论

除了神经传导速度检查(NCS)和MRI外,使用US有助于评估退变性颈椎病的神经根状况。

资助情况

无资助。

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