CAJ | 학술논문

目的：探讨颈椎不稳、颈椎管狭窄、颈髓受压程度、颈髓受压节段与 MRI-T2 WI 脊髓高信号的相关性。方法回顾性分析2006年11月—2009年11月,在河北医科大学第三医院就诊的286例脊髓型颈椎病患者的颈椎正侧位、颈椎过伸过屈位 X 线片、颈椎 MRI。结果脊髓高信号组颈椎不稳的发生率为36.2%,颈椎管狭窄的发生率为35.6%；无高信号组颈椎不稳的发生率为21.4%,颈椎管狭窄的发生率为26.8%,经过χ2检验二组间颈椎不稳和颈椎管狭窄的差异有统计学意义(P <0.05),脊髓内高信号组共174例,其中单节段受压24例,双节段受压72例,三个或者以上节段受压78例；无脊髓高信号组共112例,其中单节段受压42例,双节段受压57例,三个或者以上节段受压13例；脊髓高信号组脊髓压迫程度平均为44.7%。无脊髓高信号组脊髓压迫程度平均为38.7%；经非参数比较的秩和检验二组间的颈髓受压程度、颈髓受压节段差异有统计学意义(P <0.05),Logistic 回归模型分析结果显示颈椎不稳、颈椎管狭窄、颈髓受压程度重、颈髓多节段受压是影响脊髓高信号形成的重要因素。结论颈椎不稳、颈椎管狭窄、颈髓受压程度重、颈髓多节段受压是脊髓高信号的形成的重要因素,观察患者的这些指标有助于预测脊髓高信号形成,进而提高脊髓型颈椎病的术后满意率。
목적：탐토경추불은、경추관협착、경수수압정도、경수수압절단여 MRI-T2 WI 척수고신호적상관성。방법회고성분석2006년11월—2009년11월,재하북의과대학제삼의원취진적286례척수형경추병환자적경추정측위、경추과신과굴위 X 선편、경추 MRI。결과척수고신호조경추불은적발생솔위36.2%,경추관협착적발생솔위35.6%；무고신호조경추불은적발생솔위21.4%,경추관협착적발생솔위26.8%,경과χ2검험이조간경추불은화경추관협착적차이유통계학의의(P <0.05),척수내고신호조공174례,기중단절단수압24례,쌍절단수압72례,삼개혹자이상절단수압78례；무척수고신호조공112례,기중단절단수압42례,쌍절단수압57례,삼개혹자이상절단수압13례；척수고신호조척수압박정도평균위44.7%。무척수고신호조척수압박정도평균위38.7%；경비삼수비교적질화검험이조간적경수수압정도、경수수압절단차이유통계학의의(P <0.05),Logistic 회귀모형분석결과현시경추불은、경추관협착、경수수압정도중、경수다절단수압시영향척수고신호형성적중요인소。결론경추불은、경추관협착、경수수압정도중、경수다절단수압시척수고신호적형성적중요인소,관찰환자적저사지표유조우예측척수고신호형성,진이제고척수형경추병적술후만의솔。
Objective To investigate the correlation among cervical instability,cervical stenosis,the degree of spinal cord compression,compressed levels of spinal cord and MRI - T2 WI increased signal intensity (ISI)in the spinal cord.Methods From Nov.2006 to Nov.2009,the data of 286 cases of cervical spondy-lotic myelopathy with plain radiograph and C-spine lordotic kyphotic position was analyzed retrospective-ly.Results The rate of cervical instability was 36.2% in ISI group,21.4% in without ISI group.The rate of cervical stenosis was 35.6% in ISI group,26.8% in without ISI group.There were significant differ-ence in cervical instability and cervical stenosis between two groups throughχ2 test(P <0.05).The degree of spinal cord compression was 44.7% in ISI group,38.7% in without ISI group.There were 174 patients in ISI group,including 24 cases in signal compression level,72 cases in double-compression level,78 pa-tients in three or more compression levels.There were significant between two groups in the degree of spi-nal cord compression and compressed levels of spinal cord through nonparametric tests (P <0.05).Logistic regression analysis showed that there were the predominant correlative factors affecting the formation of ISI.Conclusion Cervical instability,cervical stenosis,the degree of spinal cord compression ,compressed levels of spinal cord are the predominant factors affecting the formation of ISI in spinal cord,which can be used to forecast the formation of ISI in spinal cord,and can increase the satisfactory rate of the surgery on cervical spondylotic myelopathy.