Change in Morphology of Intramedullary T2-Weighted Increased Signal Intensity After Anterior Decompressive Surgery for Cervical Spondylotic Myelopathy
Change in Morphology of Intramedullary T2-Weighted Increased Signal Intensity After Anterior Decompressive Surgery for Cervical Spondylotic Myelopathy
复制标题
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
DOI：
10.1097/brs.0000000000000440
复制
发表时间：
2014
期刊：
影响因子：
3
通讯作者：
V. Rajshekhar
中科院分区：
文献类型：
--
作者：
A. Vedantam;V. Rajshekhar
研究设计。回顾性研究。目标。研究脊髓型颈椎病（CSM）和骨化后纵韧带（OPLL）中枢性椎体切除术后t2加权（T2W）增加信号强度（ISI）的形态学变化及其与功能预后的关系。背景资料摘要。关于前路减压手术后T2W ISI形态学改变的数据有限。目前尚不清楚T2W ISI的改变是否对CSM/OPLL患者具有预后意义。方法。我们回顾了1996年至2010年间因CSM/OPLL接受中央皮质切除术的患者，并在术后6个月或更晚进行了随访磁共振成像（MRI）。矢状面T2W ISI分类为0型无ISI；型1，主要（bbb50 %）暗淡，边界不清；2型，主要是（bbb50 %）强度大，边界尖锐。术前及随访影像记录T2W ISI长度及有无t1加权低密度。Nurick分级测量的功能结果与MR信号变化的形态学变化相关。结果。回顾性分析64例患者（男性60例，平均年龄50±1.1岁）。平均随访时间29±3.5个月。大多数患者（71.9%）在随访时ISI类型没有变化。ISI类型改善13例（20.3%），恶化5例（7.8%）。53例患者术前ISI平均长度为26.2±3.4 mm，随访时平均长度为13.7±1.8 mm （P = 0.002）。ISI分级或长度的变化与随访时Nurick分级的变化无关（P = 0.74, P = 0.5）。结论。大多数颈椎前路减压治疗CSM/OPLL的患者，T2W ISI的类型没有改变，但T2W ISI的长度减少。在我们的研究中，T2W ISI的形态学变化与Nurick分级测量的功能结果无关。证据等级：4
Study Design. Retrospective study. Objective. To study the change in morphology of T2-weighted (T2W) increased signal intensity (ISI) and its association with functional outcome after central corpectomy for cervical spondylotic myelopathy (CSM) and ossified posterior longitudinal ligament (OPLL). Summary of Background Data. There are limited data on change in T2W ISI morphology after anterior decompressive surgery. It is unclear whether change in T2W ISI carries prognostic significance in patients with CSM/OPLL. Methods. We reviewed patients who underwent central corpectomy for CSM/OPLL between 1996 and 2010, and underwent a follow-up magnetic resonance imaging (MRI) at 6 months or later postoperatively. T2W ISI on sagittal images was classified as type 0 no ISI; type 1, predominantly (>50%) faint with an indistinct border; and type 2, predominantly (>50%) intense with a sharp border. The length of T2W ISI and the presence of T1-weighted hypointensity were also recorded on preoperative and follow-up images. Functional outcomes as measured by the Nurick grade were correlated with change in morphology of MR signal changes. Results. Sixty-four patients (60 males, mean age = 50 ± 1.1 yr) were reviewed. The mean follow-up duration was 29 ± 3.5 months. The majority of patients (71.9%) had no change in the type of ISI at follow-up. The type of ISI improved in 13 patients (20.3%), and worsened in 5 patients (7.8%). The mean length of ISI was 26.2 ± 3.4 mm preoperatively and 13.7 ± 1.8 mm at follow-up in 53 patients (P = 0.002). Change in ISI grade or length was not associated with change in Nurick grade at follow-up (P = 0.74, P = 0.5). Conclusion. The type of T2W ISI does not change, but the length of T2W ISI decreases for the majority of patients undergoing anterior cervical decompression for CSM/OPLL. In our series, change in morphology of T2W ISI did not correlate with functional outcome as measured by Nurick grade. Level of Evidence: 4