CAJ | 학술논문

目的:探讨颈椎动态MRI在脊髓型颈椎病手术入路及术式选择中的指导作用.方法:对26例在常规MRI上显示为前方1个或2个相邻节段脊髓受压的脊髓型颈椎病(CSM)患者行颈椎动态MRI检查.有15例患者在颈椎动态MRI上表现为多节段脊髓前后方受压,对此15例患者采用"颈椎后路单开门椎管成形术".术前、术后及术后1年进行JOA评分,计算手术改善率;观察颈椎前凸角变化.结果:15例患者术后JOA评分较术前明显改善(P<0.05),颈椎前凸角术前术后无显著性差异(P>0.05),术后12个月神经功能改善率为优者12例,良2例,好转1例.结论:动态颈椎MRI可以更客观真实了解脊髓受压情况.帮助术者更准确地选择手术入路及术式,取得更好的治疗效果.
목적:탐토경추동태MRI재척수형경추병수술입로급술식선택중적지도작용.방법:대26례재상규MRI상현시위전방1개혹2개상린절단척수수압적척수형경추병(CSM)환자행경추동태MRI검사.유15례환자재경추동태MRI상표현위다절단척수전후방수압,대차15례환자채용"경추후로단개문추관성형술".술전、술후급술후1년진행JOA평분,계산수술개선솔;관찰경추전철각변화.결과:15례환자술후JOA평분교술전명현개선(P<0.05),경추전철각술전술후무현저성차이(P>0.05),술후12개월신경공능개선솔위우자12례,량2례,호전1례.결론:동태경추MRI가이경객관진실료해척수수압정황.방조술자경준학지선택수술입로급술식,취득경호적치료효과.
Objective:To understand the guidance effect of cervical vertebra dynamic MRI on the choice of surgical approach and method for the treatment of cervical spondylotic myelopathy(CSM).Method:26 cases of CSM whose routine MRI showed anterior compression of spinal cord at one or two adjacent segments underwent cervical vertebra dynamic MRI,among them, 15 cases presented both anterior and posterior cord compression at multilevel on their cervical vertebral MRI.Such 15 cases received open-door laminoplasty from posterior approach(Hirabayashi),JOA score was assessed at pre- and post-operation and one year after operation respectively, effective rate of the operation was calculated.Result:The post-operative JOA score of these 15 cases was significantly improved compared that of pre-opertion(P<0.05),and the anterior curvature of cervical spine between pre-and post-operation showed no significant difference (P>0.05).The improvement rate in a year after operation was excellent in 12,good in 2,fair in 1.Conclusion:Dynamic cervical vertebra MRI can objectively indicate the true condition of spinal cord compression,it is helpful to select a right surgical approach and method and get a better outcome.