Effect of Early Postoperative Resolution of MRI Signal Intensity Changes on the Outcomes of Degenerative Cervical Myelopathy
Effect of Early Postoperative Resolution of MRI Signal Intensity Changes on the Outcomes of Degenerative Cervical Myelopathy
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术后早期 MRI 信号强度变化分辨率对退行性脊髓型颈椎病预后的影响
DOI：
10.1097/brs.0000000000004612
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发表时间：
2023
期刊：
影响因子：
3
通讯作者：
Oshima Yasushi
中科院分区：
文献类型：
--
作者：
Tozawa Keiichiro;Nagata Kosei;Ohtomo Nozomu;Ito Yusuke;Nakamoto Hideki;Kato So;Doi Toru;Taniguchi Yuki;Matsubayashi Yoshitaka;Tanaka Sakae;Oshima Yasushi
研究设计：一项回顾性队列研究。目的：研究术后信号强度增加（ISI）消退的时间是否与患者的预后有关。背景资料摘要：目前尚不清楚术后早期ISI的变化是否会影响手术结果。方法：这项回顾性队列研究评估了连续的退行性脊髓型颈椎病手术患者，2012年1月至2019年9月期间的学术医院。这些患者在术前、术后2周内（早期MRI）和术后6个月后（晚期MRI）接受了磁共振成像（MRI）。ISI分类如下：0级，无; 1级，轻度（模糊）; 2级，强烈（明亮）。将患者分为以下三组：术后ISI在早期MRI（E组）或仅在晚期MRI（L组）阶段消退的患者和ISI持续存在的患者（P组）。结果：我们纳入了204例符合分析条件的完整数据的患者，其中163例术前有ISI。49例（30.1%）患者术后ISI消退。在这49例患者中，25例在早期MRI（E组）显示ISI消退，24例仅在晚期MRI（L组）显示ISI消退。所有49例术前MRI均为1级，未发现这对手术结局有显著影响。在比较两组之间的手术结果时，E组术后日本骨科协会评分和日本骨科协会恢复率优于L组和P组，L组和P组之间无显著差异。在接受颈椎手术的退行性颈椎病患者中，加权MRI可能与更好的手术结局相关。
Study Design.A retrospective cohort study.Objective.To investigate whether the timing of postoperative resolution of increased signal intensity (ISI) in the spinal cord is associated with surgical outcomes.Summary of Background Data.It remains unclear whether changes in ISI in the early postoperative period influence surgical outcomes.Methods.This retrospective cohort study evaluated consecutive patients undergoing surgery for degenerative cervical myelopathy at a single academic hospital between January 2012 and September 2019. These patients underwent magnetic resonance imaging (MRI) preoperatively, within two weeks postoperatively (early MRI) and after six months postoperatively (late MRI). ISI was classified as follows: grade 0, none; grade 1, light (obscure); and grade 2, intense (bright). Patients were categorized into the following three groups: those with postoperative ISI resolution at early MRI (group E) or only at the late MRI (group L) stage and those whose ISI was persistent (group P). The surgical outcomes were compared between these three groups.Results.We included 204 patients with complete data eligible for the analysis, and 163 of them had preoperative ISI. Postoperative ISI regression was observed in 49 (30.1%) patients. Of these 49 patients, 25 showed ISI resolution at early MRI (group E) and 24 only at late MRI (group L). All 49 were grade 1 on preoperative MRI, and this was not found to significantly impact surgical outcomes. In comparing surgical outcomes between the groups, group E had better postoperative Japanese Orthopedic Association scores and Japanese Orthopedic Association recovery rates than groups L and P. No significant differences were observed between groups L and P.Conclusions.Early resolution of preoperative grade 1 ISI on postoperative T2-weighted MRI may be associated with better surgical outcomes in patients with degenerative cervical myelopathy undergoing cervical spinal surgery.
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吸烟对脊髓型颈椎病手术治疗后脊髓愈合的影响
DOI：
10.1016/j.spinee.2016.07.007
发表时间：
2016
期刊：
The Spine Journal
影响因子：
--
作者：
David J. Kusin;N. Ahn
通讯作者：
N. Ahn
影响因子：
4.8
作者：
Arvin, Babak;Kalsi-Ryan, Sukhvinder;Fehlings, Michael G.
通讯作者：
Fehlings, Michael G.
影响因子：
1.6
作者：
Worley, Nancy;Buza, John;Passias, Peter G.
通讯作者：
Passias, Peter G.
影响因子：
3
作者：
Fehlings, Michael G.;Furlan, Julio C.;Vaccaro, Alexander R.
通讯作者：
Vaccaro, Alexander R.
脊髓型颈椎病前路减压手术后髓内T2加权信号强度增加的形态变化
影响因子：
3
作者：
A. Vedantam;V. Rajshekhar
通讯作者：
V. Rajshekhar