Suzuki M, Shimamura T
Department of Orthopaedic Surgery, School of Medicine, Iwate Medical University, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1994 Jan;68(1):1-13.
To investigate the morphological changes in the cervical spinal cord in patients with cervical myelopathy, we examined the axial anatomy of the cervical spinal cord and the spinal canal using MRI and CT scans. This study involved 35 patients (mean age = 56.8) with cervical myelopathy and 118 adult normal volunteers (mean age = 48.1) as controls. The transverse area of the spinal cord was measured on MR images (T1 images), while the transverse area of the spinal canal was measured on CT. In normal subjects, the transverse area, the sagittal diameter, and the coronal diameter of the spinal cord showed a significant positive correlation with body height, and a significant negative correlation with age. No significant difference was identified between males and females. The transverse area, the sagittal diameter, the coronal diameter, and the ratio of the sagittal/coronal diameter of the spinal cord and the spinal canal showed significant positive correlations among each other in normal subjects, but no significant correlation was noted in the patients with cervical myelopathy. There was no significant difference between the normal subjects and the patients in the transverse area or in the ratio of the sagittal/coronal diameter of the spinal cord at the levels without cord compression. However, the transverse area of the spinal canal in the patients with myelopathy was significantly smaller than that of normal subjects. In conclusion, a poor or no correlation between the size of the spinal cord and the spinal canal is a frequent finding in patients with myelopathy. Furthermore, this study suggests that patients with myelopathy present a narrow spinal canal more frequently than do normal subjects.
为了研究脊髓型颈椎病患者颈段脊髓的形态学变化,我们使用磁共振成像(MRI)和计算机断层扫描(CT)对颈段脊髓和椎管的轴向解剖结构进行了检查。本研究纳入了35例脊髓型颈椎病患者(平均年龄=56.8岁)和118名成年正常志愿者(平均年龄=48.1岁)作为对照。在磁共振图像(T1加权像)上测量脊髓的横截面积,而在CT上测量椎管的横截面积。在正常受试者中,脊髓的横截面积、矢状径和冠状径与身高呈显著正相关,与年龄呈显著负相关。男性和女性之间未发现显著差异。在正常受试者中,脊髓和椎管的横截面积、矢状径、冠状径以及矢状径与冠状径的比值之间均呈显著正相关,但在脊髓型颈椎病患者中未发现显著相关性。在无脊髓受压节段,正常受试者与患者在脊髓横截面积或矢状径与冠状径的比值方面无显著差异。然而,脊髓型颈椎病患者的椎管横截面积明显小于正常受试者。总之,脊髓型颈椎病患者脊髓与椎管大小之间相关性差或无相关性是常见现象。此外,本研究表明,脊髓型颈椎病患者出现椎管狭窄的频率高于正常受试者。