慢性压迫性颈脊髓病减压后的功能评价与MR观察  

The functional evaluation and MR observation for the chronic compressive cervical myelopathy after decompression

作　　者：孙立高[1] 杨利民[1] 彭明[1] 张国庆[1] 谢鸣[1] 李维林[1] 

机构地区：[1]青岛市立医院骨科,山东省青岛市胶州路1号266011

出　　处：《中国脊柱脊髓杂志》1999年第5期243-245,共3页Chinese Journal of Spine and Spinal Cord

摘　　要：目的 :探讨慢性压迫性颈脊髓病压迫程度及MR表现与术后功能恢复的相互关系。方法 :选择 3年中经过减压治疗的颈脊髓病 32例 ,再经过 1～ 3年的临床随访及MR复查 ,采用JOA评分法进行功能评价 ,并对MR图像进行测量与观察。结果 :( 1 )减压后椎管截面积增加了 99 2 1 % ;脊髓截面积增加了6 3 39% ;脊髓矢状径增加了 33 87% ;JOA评分病残改善率为 6 2 2 %。 ( 2 )术前脊髓矢状面图像T1WI及T2WI均为正常信号者 1 7例 ,T1WI正常T2WI可见片状增强信号者 1 5例 ,术后病残改善率分别为88 6 8%和 35 78% ,两组手术前后评分及病残改善率均有显著性差异 (P <0 0 0 1 )。结论 :MR图像显示慢性压迫性颈脊髓病脊髓内异常变化可以更直接地判断脊髓功能恢复状况 ;对有发育性椎管狭窄的颈椎失稳应当早期减压治疗。Objective:To study the relationship between compressive extent,MR imaging and postoperative functional restoration of the chronic compressive cervical myelopathy.Method:32 cases of cervical spondylosis had received decompression treatment in the past 3 years.MR observation and measurement,JOA assessment had been mad in all above patients within 1～3 year clinical follow up.Result:After the decompression operation,(1)The cross area of the spinal canal increased 99 21%,The cross area of the spinal cord increased 63 39%.The saggittal diameter of the spinal cord increased 33 87%.JOA disability improve rate was 62 27%.(2)There were 17 cases with normal T1WI and T2WI spinal cord signal,the others with normal T1WI and T2WI and long fragmental T2WI signal.JOA disability improve rate was 88 68% and 35 87% respectively.There were significant difference(P<0 001) in JOA assessments between preoperation and postoperation,as well as disability improve rate in these two groups.Conclusion:The abnormal MR signal in the spinal cord influnce the functional recovery directly.Ccervical spinal unstability and developmental spinal stenosis should be decompressed early. Author′s address\ Department of Orthopedics,Qingdao Municipal Hospital,Qingdao,Shandong,266011

关 键 词：颈脊髓病 功能评价 MR 外科手术 治疗 

分 类 号：R651.2[医药卫生—外科学]