摘要
目的探讨高龄脊髓型颈椎病手术疗效与MRI所见的关系。方法回顾研究行颈前路或后路减压的脊髓型颈椎病37例，平均随访16．4个月（6～55个月）。大于60岁为观察组（A组），小于60岁为对照组（B组），评估比较两组术前术后JOA评分、术前术后MRI影像。结果颈椎病术后改善率A组（47．4±13．5）％，B组（65.6±15．8）％；MRI脊髓横截面积，术前A组（38．5±11．5）mm^2，B组（48．3±12．8）mm^2，术后A组（47．9±12．6）mm^2，B组（61．6±11．4）mm^2，A、B两组数据均有显著性差异。术后脊髓高信号不变比例，A组为83．3％，B组为20．0%，A组信号不变比例高.平均患病时间A组（15．2±11．8）个月，B组（7．7士6．17）个月，二者有显著性差异。结论高龄脊髓型颈椎病预后与颈髓最明显受压处的横截面积关系密切，面积越小，预后则越差；高龄患者疗效较年轻人差，与病程长、脊髓压迫重、脊髓变性等因素有关。
Objective To investigate correlation between the surgical effect and MR imaging on cervical spondylotic myelopathy in the aged. Methods 37 cases with Cervical Spondylotic Myelopathy（CSM） underwent anterior or posterior surgical decompression. The average follow-up was i6.4 months（range, 6 to 55 months）. According to age, the cases were divided into two groups. Group A： The age was more than 60 years old. Group B： The age was less than 60 years old. Two groups cases were evaluated and compared with preoperational and postoperational JOA scores, preoperational and postoperational MR imaging. Results According to JOA score system, the excellent results were obtained in （47.4±13.5）% Group A and （65.6±15.8）% in Group B. The area of spinal cord in Group A was average （38.5±11.5） mm^2 in preoperation and （47.9±12.6） mm^2 in postoperation, While, Group B was average （48.3±12.8） mm^2 in preoperation and （61.6±11.4） mm^2 in postoperation. We compared high signal intensity on MRI of spinal cord between preoperation and postoperation. 83.3% high signal of MRI were the same in Group A and 20. 0% high signal of MRI were the same in Group B. There was statistically significant difference between Group A and B. Average time of disease was （15.2±11.8） months in Group A and （7.7±6.17） months in Group B. Conclusion Surgical effect on CSM in the aged was related with compressed spinal cord transaction area of MRI. The area was more small and the surgical effect would be more poor. Surgical effect of CSM in aged cases was poorer than younger cases. The causes were related to longer cource of disease,serious compression myelopaty and spinal cord degeneration.
出处
《实用骨科杂志》
2007年第11期641-643,共3页
Journal of Practical Orthopaedics
关键词
老年人
颈椎病
手术
MRI
the aged
cervical spondylotic myelopathy
operation
MRI
