摘要
目的观察脊髓型颈椎病患者行双开门椎管成形术后脊髓肿胀与髓内二乙三胺五乙酸钆络合物(Gd-DTPA)增强MRI的关系。方法选择2017年1月~2019年12月在本院接受双开门椎管成形术治疗的147例脊髓型颈椎病患者,根据术前有无髓内Gd-DTPA增强分为增强组和非增强组。观察患者术后1个月脊髓肿胀的发病率及术后1年肿胀的变化、脊髓T2WI高信号区的形态、术后1年JOA颈椎病评分及恢复率。结果增强组术后1个月的脊髓肿胀发生率显著高于非增强组(P<0.05);增强组术后1年的脊髓肿胀恢复率低于非增强组,但差异无统计学意义(P>0.05)。术后两组JOA评分均显著高于术前(P<0.05),但增强组脊髓肿胀、无脊髓肿胀患者的术后JOA评分均显著低于非增强组脊髓肿胀、无脊髓肿胀患者(P<0.05);术后增强组、非增强组脊髓肿胀患者的JOA评分和恢复率均显著低于增强组、非增强组的无脊髓肿胀者(P<0.05)。脊髓肿胀患者以弥漫为主要表现,非脊髓肿胀患者以蛇眼型为主要表现,两者差异有统计学意义(P<0.05)。多元线性回归分析显示,Gd-DTPA增强是影响术后JOA恢复率的风险因素(P<0.05),脊髓肿胀不影响术后JOA恢复率(P>0.05)。结论髓内Gd-DTPA增强与脊髓型颈椎病患者行双开门椎管成形术后脊髓肿胀和预后不良相关。
Objective To observe the relationship between spinal cord swelling and Gd-DTPA enhanced MRI in patients with cervical spondylotic myelopathy after double door laminoplasty.Methods From January 2017 to December 2019,147 patients with cervical spondylotic myelopathy who underwent double door laminoplasty in our hospital were selected in this research.According to the presence or absence of intramedullary Gd-DTPA enhancement,the patients were divided into enhancement group and non-enhancement group.The incidence of spinal cord swelling at 1 month postoperatively and the changes in swelling at 1 year postoperatively,the morphology of the hyperintense areas on T2WI of the spinal cord,the JOA cervical spondylopathy score at 1 year postoperatively,and the recovery rate were observed.Results The incidence rate of spinal cord swelling in the enhanced group was higher than that in the non-enhanced group at 1 month after surgery(P<0.05),and the recovery rate of spinal cord swelling in the enhanced group was lower than that in the non-enhanced group at 1 year after surgery,but the difference was not statistically significant(P>0.05).After operation,the JOA scores of the enhancement group and non-enhancement group were higher than before operation(P<0.05).The postoperative JOA scores of the enhancement group with spinal cord swelling and no spinal cord swelling were lower than those of the non-enhancement group(P<0.05).The postoperative JOA score and recovery rate of patients with spinal cord swelling in two groups were lower than those in patients without spinal cord swelling(P<0.05).The main manifestation of patients with spinal cord swelling was diffuse,and the main manifestation of patients without spinal cord swelling was snake-eye type,the difference between the two groups was statistically significant(P<0.05).Multiple linear regression analysis showed that enhancement of Gd-DTPA was a risk factor of the recovery rate of JOA(P<0.05),and spinal cord swelling did not affect the recovery rate of JOA after surgery(P>0.05).C
作者
聂玉霞
黄文荣
苏兰芳
万江花
NIE Yu-xia;HUANG Wen-rong;SU Lan-fang;WAN Jiang-hua(Department of Imaging,Huangliu Bokang Hospital,Ledong,Hainan 572536,China;Department of Imaging,Hainan West Central Hospital,Danzhou,Hainan 571700,China;Department of Imaging,the First Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570102,China;Department of Radiology,the First Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570102,China)
出处
《颈腰痛杂志》
2021年第5期606-609,共4页
The Journal of Cervicodynia and Lumbodynia
关键词
脊髓型颈椎病
脊髓肿胀
磁共振成像
二乙三胺五乙酸钆络合物
双开门椎管成形术
cervical spondylotic myelopathy
spinal cord swelling
magnetic resonance imaging
gadolinium diethylenetriamine pentaacetate complex
double door laminoplasty
