Omi Hirotsugu, Yokoyama Toru, Naraoka Takuya, Omi Sanae, Takeuchi Kazunari
Department of Orthopaedic Surgery, Omi Orthopaedic Clinic, Hirosaki, Aomori, Japan.
Department of Orthopaedic Surgery, Odate Municipal General Hospital, Odate, Akita, Japan.
Spine Surg Relat Res. 2022 Jun 13;6(6):631-637. doi: 10.22603/ssrr.2022-0014. eCollection 2022 Nov 27.
Cervical spine surgery reduces falls and subsequent femoral fractures. Nonetheless, current evidence on the prevalence of cervical cord compression (CCC) and increased signal intensity (ISI) in patients with femoral fractures is limited. We aimed to determine the prevalence of CCC and ISI and characterize the physical status and imaging findings using cervical spine magnetic resonance imaging (MRI) and brain computed tomography (CT) in patients with femoral fractures.
This study included 173 patients (140 women, 33 men) with femoral fractures caused by falling, who underwent both cervical spine MRI and brain CT. CCC cases classified as grade 2 (compression of less than one-third of the spinal cord) or higher were investigated. The ISI of the severely affected intervertebral disc level was evaluated using T2-weighted MRI. Hand grip strength and myelopathic signs were also evaluated. Data analysis was performed using the χ test, Fisher's exact test, and Student's -test.
Among the 173 patients, 83 (48.0%) had CCC, 29 (16.8%) had ISI, and 68 (39.3%) had abnormal brain CT findings. There was no ISI in patients in the non-CCC group. The patients' average age in the CCC group was significantly higher than that in the non-CCC group. There was no significant difference in the proportion of myelopathic sign and abnormal brain CT findings between the CCC and non-CCC groups or between the ISI and non-ISI groups. Bilateral hand grip strength was significantly negatively correlated with the stenosis rate (right, p=0.047; left, p=0.0018).
In conclusion, our study showed that patients with femoral fractures had a high frequency of cervical canal stenosis and intracranial lesions using cervical spine MRI and brain CT.
颈椎手术可减少跌倒及随后的股骨骨折。然而,目前关于股骨骨折患者颈髓受压(CCC)和信号强度增加(ISI)患病率的证据有限。我们旨在确定CCC和ISI的患病率,并使用颈椎磁共振成像(MRI)和脑计算机断层扫描(CT)对股骨骨折患者的身体状况和影像学表现进行特征分析。
本研究纳入了173例因跌倒导致股骨骨折的患者(140例女性,33例男性),这些患者均接受了颈椎MRI和脑CT检查。对分类为2级(脊髓受压小于三分之一)或更高等级的CCC病例进行了研究。使用T2加权MRI评估受严重影响椎间盘水平的ISI。还评估了握力和脊髓病体征。使用χ检验、Fisher精确检验和Student's检验进行数据分析。
在173例患者中,83例(48.0%)有CCC,29例(16.8%)有ISI,68例(39.3%)有脑CT异常表现。非CCC组患者中无ISI。CCC组患者的平均年龄显著高于非CCC组。CCC组与非CCC组之间或ISI组与非ISI组之间,脊髓病体征比例和脑CT异常表现无显著差异。双侧握力与狭窄率显著负相关(右侧,p = 0.047;左侧,p = 0.0018)。
总之,我们的研究表明,使用颈椎MRI和脑CT检查发现,股骨骨折患者颈椎管狭窄和颅内病变的发生率较高。