不同颈髓MRIT_2/T_1信号比值范围对颈椎后纵韧带骨化症术式选择的意义  

CLASSIFICATION OF QUANTIFYING MRI T_2/T_1 SIGNAL ON CHOICE OF SURGICAL APPROACH FOR CERVICAL OSSIFICATION OF POSTERIOR LONGITUDINAL LIGAMENT

作　　者：申沧海[1] 张鹏[1] 申勇[1] 丁文元[1] 张英泽[2] 曹俊明[1] 

机构地区：[1]河北医科大学第三医院脊柱外科,河北石家庄050051 [2]河北医科大学第三医院骨科创伤急救中心,河北石家庄050051

出　　处：《河北医科大学学报》2013年第9期1015-1019,共5页Journal of Hebei Medical University

摘　　要：目的 探讨颈椎后纵韧带骨化症（ossification of posterior longitudinal ligament,OPLL）不同MRI T2/T1信号比值范围对手术方式选择的意义.方法 2004年3月-2010年5月OPLL患者85例,分别接受颈椎前路（44例）或后路（41例）术式治疗.所有患者术前均行高分辨率1.5 T MRI并计算T2/T1信号比值,比值数据按大小平均分为低、中、高T2/T1信号比值组.重点分析各组内前路和后路术式手术前、后日本骨科协会（Japanese Orthopaedic Association,JOA）评分及改善率.结果 所有85例患者获得1~5年随访.中位随访17.5个月.低、中、高T2/T1信号比值组在年龄、病程、术前、术后JOA评分及改善率等指标间差异均有统计学意义（P〈0.01）.在低信号比值组,前路和后路术式间比较术后JOA评分及改善率差异无统计学意义（P〉0.05）.在中、高信号比值组,前路术式术后JOA评分及改善率均高于后路术式,2种术式间差异有统计学意义（P〈0.05）.结论 在中、高MRI T2/T1信号比值范围下,前路术式对颈椎OPLL患者的脊髓神经功能的改善优于后路术式.Objective To assess the classification of quantifying MRI T2/T1 weighted imagining signal intensity ratio（ MRI T2/T1 SI ratio） on the choice of the surgical approach for cervical ossification of posterior longitudinal ligament （OPLL）. Methods From ＇March 2004 to May 2010,85 OPLL patients treated with anterior or posterior approaches for OPLL were enrolled retrospectively in this study. Magnetic resonance imaging 1.5T was performed in all patients before surgery. Patients were divided into three groups according to T2/T1 SI ratio（ low, intermediate, and high T2/T1 ratio groups）. Pre- and postoperative Japanese Orthopaedic Association （ JOA ） approaches were compared in different T2/T1 for 1 -5 years, with the median of 17. 5 significant differences, disease duration, pre- score and recovery ratebetween anterior and posterior ratio groups. Results All OPLL patients were followed up months. The three T2/T1 ratio groups in the age showed and postoperative JOA score and recovery rate（P 〈0.01 ）. In low T2/T1 ratio group, there was no significant difference regarding pre-and postoperative JOA scoreand recovery rate between anterior and posterior approaches（ P 〉 0.05 ）. In intermediate and high T2/T1 ratio groups, postoperative JOA score and recovery rate of posterior approach were significantly lower than those of anterior approach （ P 〈 0. 05 ）. Conclusion The anterior approach is more effective than posterior approach for treating cervical OPLL characterized by intramedullary intermediate and high T2/T1 SI ratio.

关 键 词：颈椎 骨化 后纵韧带 磁共振成像 

分 类 号：R686.5[医药卫生—骨科学]