摘要
目的:探讨颈椎后纵韧带骨化症患者的MRI影像特点及其与手术疗效的关系。方法:总结2002年5月至2005年6月在我院进行后路减压手术治疗的48例OPLL患者术前、术后的MRI影像资料,根据术前骨化物横断面形态分为矩型(A组)、山丘型(B组)和蘑菇型(C组)。分析不同类型患者脊髓高信号情况和术后脊髓横截面积扩大率与手术疗效的关系。结果:所有患者随访1～4年,平均2.1年。A、B、C组患者术前存在脊髓高信号者分别为4例(26.7%)、9例(39.1%)和7例(70.0%);术后分别为8例(53.3%)、14例(60.8%)和7例(70.0%);术后脊髓横截面积扩大率分别为(42.8±5.6)%、(38.4±7.2)%和(22.5±7.7)%;JOA评分改善率分别为(61.8±12.8)%、(51.8±8.9)%和(37.4±9.3)%。A、B组的术前高信号、术后脊髓横截面积扩大率与术后JOA评分改善率与C组比较均有显著性差异(P<0.05)。结论:MRI上骨化物表现为蘑菇型的OPLL患者术前往往存在脊髓高信号,术后脊髓横截面积扩大率低,手术疗效差,而矩型和山丘型患者手术治疗效果相对较好。
Objective：To discuss the relationship between MRI findings and surgical outcome of ossification of posterior longitudinal ligament （OPLL）.Method：Between May 2002 and June 2005,48 patients with OPLL were treated by posterior decompression in our hospital.Pre- and post-operative MR images were reviewed retrospectively ,and were categorized into rectangle,hill and mushroom types according to the cross-sectional profile of ossification.The intensity changes and expansive rate of spinal cord were studied with respect to the surgical outcomes of different types of ossification.Result：The follow-up period was from 1 to 4 years,with an average of 2.1 years.For rectangle- , hill- , and mushroom-type groups,the high intensity changes of the spinal cord were preoperatively observed in 4（26.7%） patients,9（39.1%）,and 7（70.0%） respectively;postoperatively in 8（53.3%） patients,14（60.8%）,and 7（70.0%） respectively.The postoperative expansive rate of spinal cord was （42.8±5.6）% for rectangle, （38.4±7.2）% for hill,and （22.5±7.7）% for mushroom.The average improved JOA rate was （61.8±12.8）% for rectangle,（51.8±8.9）% for hill,and （37.4±9.3）% for mushroom respectively. Conclusion：The patients with mushroom-type ossification on MRI usually have high intensity change of spinal cord preoperatively ,which can result in low expansive degree of spinal cord and poor surgical outcome.Those with rectangle-or hill-type ossification have a better outcome.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2007年第3期186-189,共4页
Chinese Journal of Spine and Spinal Cord
关键词
后纵韧带骨化症
MRI
颈椎
Ossification of posterior longitudinal ligament
MRI
Cervical spine
