脊髓型颈椎病手术疗效与MRI的相关性研究.doc

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1、脊髓型颈椎病手术疗效与MRI的相关性研究作者：陈刚，杜斌，茆军，夏建龙，严培军，薛锦标【摘要】目的探讨高龄脊髓型颈椎病手术疗效与MRI所见的关系。方法回顾研究行颈前路或后路减压的脊髓型颈椎病37例，平均随访16.4个月(6～55个月)。大于60岁为观察组(A组)，小于60岁为对照组(B组)，评估比较两组术前术后JOA评分、术前术后MRI影像。结果颈椎病术后改善率A组(47.4±13.5)％，B组(65.6±15.8)％；MRI脊髓横截面积，术前A组(38.5±11.5)mm2，B组(48.3±12.8)mm2，术后A组(47

2、.9±12.6)mm2，B组(61.6±11.4)mm2，A、B两组数据均有显著性差异。术后脊髓高信号不变比例，A组为83.3％，B组为20.0％，A组信号不变比例高。平均患病时间A组(15.2±11.8)个月，B组(7.7±6.17)个月，二者有显著性差异。结论高龄脊髓型颈椎病预后与颈髓最明显受压处的横截面积关系密切，面积越小，预后则越差；高龄患者疗效较年轻人差，与病程长、脊髓压迫重、脊髓变性等因素有关。【关键词】老年人；颈椎病；手术；MRICorrelationbetweentheSurgicalEffectandMRIm

3、agingonCervicalSpondyloticMyelopathyintheAgedAbstract：ObjectiveToinvestigatecorrelationbetweenthesurgicaleffectandMRimagingoncervicalspondyloticmyelopathyintheaged.Methods37caseswithCervicalSpondyloticMyelopathy(CSM)underwentanteriororposteriorsurgicaldecompression.

4、Theaveragefollowupwas16.4months(range，6to55months).Accordingtoage，thecasesweredividedintotwogroups.GroupA：Theagewasmorethan60yearsold.GroupB：Theagewaslessthan60yearsold.TwogroupscaseswereevaluatedandcomparedwithpreoperationalandpostoperationalJOAscores，preoperation

5、alandpostoperationalMRimaging.ResultsAccordingtoJOAscoresystem，theexcellentresultswereobtainedin(47.4±13.5)％GroupAand(65.6±15.8)％inGroupB.TheareaofspinalcordinGroupAwasaverage(38.5±11.5)mm2inpreoperationand(47.9±12.6)mm2inpostoperation，While，GroupBwasaverage(48.3±12

6、.8)mm2inpreoperationand(61.6±11.4)mm2inpostoperation.WecomparedhighsignalintensityonMRIofspinalcordbetweenpreoperationandpostoperation.83.3％highsignalofMRIwerethesameinGroupAand20.0％highsignalofMRIwerethesameinGroupB.Therewasstatisticallysignificantdifferencebetween

7、GroupAandB.Averagetimeofdisease5was(15.2±11.8)monthsinGroupAand(7.7±6.17)monthsinGroupB.ConclusionSurgicaleffectonCSMintheagedwasrelatedwithcompressedspinalcordtransactionareaofMRI.Theareawasmoresmallandthesurgicaleffectwouldbemorepoor.SurgicaleffectofCSMinagedcases

8、waspoorerthanyoungercases.Thecauseswererelatedtolongercourceofdisease，seriouscompressionmyelopatyandspinalcorddegeneration.Keywords：theage