基于3D水平颈椎管容积测量与脊髓型颈椎病临床评估的相关性研究  

Relationship between three-dimensional measurement of cervical spinal canal volume and clinical evaluation of cervical spondylosis myelopathy

作　　者：肖良[1] 徐宏光[1] 王凌挺[1] 陈学武[1] 杨晓明[1] 张玙[1] 

机构地区：[1]皖南医学院附属弋矶山医院脊柱骨科,安徽芜湖241001

出　　处：《中国矫形外科杂志》2016年第15期1409-1414,共6页Orthopedic Journal of China

基　　金：国家自然科学基金(编号:81572185);安徽省芜湖市科技惠民计划(编号:2013hm39)

摘　　要：[目的]对颈椎管容积在三维水平进行测量,探讨其对于预测多节段脊髓型颈椎病发病、手术疗效评估等方面的应用价值。[方法]回顾性收集48例经本院脊柱骨科手术治疗的多节段脊髓型颈椎病患者颈椎CT资料,利用医学图像处理软件Mimics 15.0对其椎管容积进行测量,测量指标包括:骨性椎管容积、纤维性椎管容积、椎管容积占有率、脊髓受累节段数。患者神经功能与手术疗效评价指标包括:JOA评分、VAS疼痛评分,通过Pearson相关性分析、多元线性回归分析试图找出影响脊髓型颈椎病发病、手术疗效的重要因素。[结果]患者术前和术后随访JOA评分、VAS评分比较差异有统计学意义(P<0.01),Pearson相关性分析提示纤维性椎管容积与术前JOA评分相关性有统计学意义(P<0.05),椎管容积占有率与术前和术后JOA评分相关性有统计学意义(P<0.01)。多元线性回归分析提示骨性椎管容积、纤维性椎管容积和椎管容积占有率影响术前JOA评分,其中椎管容积占有率影响最大。[结论]椎管容积占有率可以反映脊髓对外界压迫的代偿能力。利用Mimics软件可以定量测量椎管容积,为诊断多节段脊髓型颈椎病和选择合适的治疗时机提供了一种新方法。[ Objective] To perform three -dimensional measurement of the cervical spinal canal volume, and to investi- gate its value in prediction of the incidence of multi - segmental cervical spondylosis myelopathy and evaluation of the efficacy of surgical treatment. [ Methods ] A retrospective analysis was performed on the computed tomography data of cervical spine from 48 patients with multi - segmental cervical spondylosis myelopathy who received surgical treatment at Department of Spine in our hospital. A medical image processing software, Mimicsl 5.0, was used to measure the spinal canal volume. The measurement in- dices included bony canal volume, fibrous canal volume, spinal canal occupancy, and tile number of oppressed spinal cord segments. The Japanese Orthopaedic Association （JOA） score and Visual Analog Scale （VAS） pain score were used to evaluate neurological function and the efficacy of surgical treatment in patients. Pearson＇s correlation analysis and multiple linear regression analysis were used to identify important influencing factors for the incidence of cervical spondylosis myelopathy and the efficacy of surgical treatment. [Results] There were significant differences in JOA score and VAS score after surgery （P 〈0. 01 ） . The Pearson＇ s correlation analysis indicated that fibrous canal volume was significantly correlated with preoperative JOA score （ P 〈 0. 05 ）, and spinal canal occupancy was significantly correlated with preoperative and postoperative JOA scores （ P 〈 0. 01 ） The multiple linear regression analysis indicated that bony canal volume, fibrous canal volume, and spinal canal occupancy were influencing factors for preoperative JOA score, in which spinal canal occupancy had the greatest impact on preoperative JOA score. [ Conclusion] Spinal canal occupancy can reflect the compensatory capacity of spinal cord against the external op-pression. Mimics software can be used to quantitatively measure the cervical spinal canal volume, which provides a new method for

关 键 词：三维 椎管容积测量 多节段脊髓型颈椎病 

分 类 号：R681.55[医药卫生—骨科学]