Observations in the diagnosis of cervical myelopathy in patients suffering from diabetes mellitus
Observations in the diagnosis of cervical myelopathy in patients suffering from diabetes mellitus
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DOI：
10.1038/sc.2012.56
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发表时间：
2012-12-01
期刊：
影响因子：
2.2
通讯作者：
Endo, T.
中科院分区：
文献类型：
--
作者：
Okada, M.;Minamide, A.;Endo, T.
目的：确定任何有助于糖尿病(DM)患者颈脊髓病变诊断的观察结果。研究设计：回顾对比研究。地点：日本和歌山医科大学骨科。方法：回顾分析111例脊髓型颈椎病患者，其中非糖尿病患者56例(N组)，轻度糖尿病患者26例(M组)，重度糖尿病患者29例(S组)。当患者有以下一种或多种病史时，我们将其视为重症糖尿病患者：(A)服药10年以上；(B)糖化血红蛋白高于7.0%；(C)糖尿病视网膜病变；(D)周围神经传导速度延迟。比较3组患者术前神经功能评分：(1)10项S试验，量化手部脊髓病；(2)感觉障碍；(3)深肌腱反射；(4)霍夫曼、特罗姆纳和巴宾斯基反射；(5)膀胱功能障碍。S组深肌腱反射明显减少，感觉障碍和膀胱功能障碍差异无统计学意义。S组Hoffmann‘s反射和Tromner’s反射明显消失，但巴宾斯基反射阳性率两组间差异无统计学意义。结论：10s试验和巴宾斯基反射有助于糖尿病颈脊髓病变的诊断。脊髓(2012年)50,878-881；doi：10.1038/sc.2012.56；在线发布
Objectives: To identify any observations that could aid in the diagnosis of cervical myelopathy in patients suffering from diabetes mellitus (DM). We compared the preoperative neurological findings in patients with cervical myelopathy among non-diabetics, mild diabetics and severe diabetics.Study Design: A retrospective comparative study.Setting: Department of Orthopaedic Surgery, Wakayama Medical University, Japan.Methods: We retrospectively reviewed 111 patients who had undergone laminoplasty for cervical compressive myelopathy: 56 without DM (group N), 26 with mild diabetes (group M) and 29 with severe diabetes (group S). We regarded the patients as severe diabetics when they had a history of one or more of following; (a) more than 10 years of medication; (b) more than 7.0% HbA1c; (c) diabetic retinopathy; and (d) delayed conduction velocity of peripheral nerves. For preoperative neurological assessment we compared the following among the three groups: (1) the 10 s test whereby the myelopathy in the hand was quantified; (2) sensory disturbance; (3) deep tendon reflexes; (4) Hoffmann's, Tromner's and Babinski's reflexes; and (5) bladder dysfunction.Results: There was no significant difference preoperatively in the 10 s test between the groups. Deep tendon reflexes were significantly decreased in group S. There were no significant differences in sensory disturbance and bladder dysfunction. Although Hoffmann's and Tromner's reflexes significantly disappeared in group S, there was no significant difference in positivity of Babinski's reflex between the groups.Conclusions: The 10s test and Babinski's reflex are helpful for the diagnosis of cervical myelopathy in patients suffering from DM. Spinal Cord (2012) 50, 878-881; doi:10.1038/sc.2012.56; published online 15 May 2012