Wu W, Thuomas K A, Hedlund R, Leszniewski W, Vavruch L
Department of Diagnostic Radiology, University Hospital, Linköping, Sweden.
Acta Radiol. 1996 Mar;37(2):153-61. doi: 10.1177/02841851960371P132.
The aim of the investigation was to evaluate poor outcome following spinal and cervical surgery.
A total of 146 consecutive patients operated with anterior discectomy and fusion (ADF) with the Cloward technique were investigated. Clinical notes, plain radiography, CT, and fast spin-echo (FSE) images were retrospectively evaluated.
Some 30% of the patients had unsatisfactory clinical results within 12 months after surgery; 13% had initial improvement followed by deterioration of the preoperative symptoms, while 14.4% were not improved or worsened. Disc herniation and bony stenosis above, below, or at the fused level were the most common findings. In 45% of patients, surgery failed to decompress the spinal canal. In only 4 patients was no cause of remaining myelopathy and/or radiculopathy found. FSE demonstrated a large variety of pathological findings in the patients with poor clinical outcome after ADF. Postoperatively, patients with good clinical outcome had a lower incidence of pathological changes.
FSE is considered the primary imaging modality for the cervical spine. However, CT is a useful complement in the axial projection to visualize bone changes.
本研究旨在评估脊柱和颈椎手术后的不良预后情况。
对总共146例采用Cloward技术行前路椎间盘切除融合术（ADF）的连续患者进行了研究。对临床记录、X线平片、CT及快速自旋回波（FSE）图像进行了回顾性评估。
约30%的患者在术后12个月内临床效果不满意；13%的患者最初症状改善但随后术前症状恶化，而14.4%的患者无改善或病情加重。椎间盘突出以及融合节段上方、下方或融合节段处的骨质狭窄是最常见的发现。45%的患者手术未能使椎管减压。仅4例患者未发现残留脊髓病和/或神经根病的病因。FSE显示ADF术后临床效果不佳的患者存在多种病理表现。术后，临床效果良好的患者病理改变发生率较低。
FSE被认为是颈椎的主要影像学检查方法。然而，CT在轴位投影中对观察骨质改变是一种有用的补充。
