摘要
[目的]评价创伤性颈脊髓损伤早期手术的效果及MRI揭示预后的价值。[方法]2001年9月～2004年8月，对36例创伤性颈脊髓损伤患者行手术治疗，伤后72h内为早期手术，72h后为晚期手术。术前MRIR加权像髓内信号改变长度〉20mm为长变化，信号改变≤20mm或无明显信号改变为短变化。随访时间为24～48个月，平均32个月。采用日本骨科学会（JOA）标准进行人院时和随访时脊髓功能评分，通过计算恢复率评价神经改善状况。[结果]术后24个月随访时，早期手术组恢复率高于晚期手术组（P〈0．01）；MRI T2加权像信号短变化组恢复率高于信号长变化组（P〈0．01），差异均有统计学意义。不同手术时机与MRI T2加权像脊髓信号改变间存在交互作用。[结论]创伤性颈脊髓损伤后，手术时间越早，MRI T2加权像脊髓信号变化越短，术后神经功能恢复率越高：
[ Objective] To evaluate the early surgical outcome for cervical traumatic spinal cord injury. （CTSCI） and the predictive value of magnetic resonance （MR） imaging in the setting of CTSCI. [ Method] The retrospective study was performed on 36 patients with CTSCI from September 2001 to August 2004 who received early （ 〈72 h） and late （ 〉72 h） surgical treatment respectively. Desion length in the T2 - weighted MR imaging of the patients with CTSCIs was classified into two groups,i, e. long variation （ 〉 20 ram） and short variation （ ≤20 ram）. The average follow-up time was 32 months （range 24 to 48 ）. Spinal function was evaluated by JOA （Japanese Orthopaedic Association） guidance at hospital admission and at the follow-up time of 24^th month, and neurological improvement was expressed by the recover, rate. [ Result] At the follow-up review of 24^th month ,the neurological improvement according to the reeovery rate of the early surgical treatment group was higher than late surgical treatment group （P 〈 0.01 ） ,and the recover＇ rate of T2 -weighted MR imaging short variation group was higher than long variation group （P 〈0.01 ）. Interaction exists in different operation opportunity and signal change of spinal cord in T2 -weighted MRI image. [ Conclusion] After CTSCI, the earlier the operation is performed,and the shorter the change of T2 -weighted MRI image is, the higher recovery possibility of neural function will be.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2008年第16期1215-1217,共3页
Orthopedic Journal of China
关键词
颈椎
脊髓损伤
早期手术
核磁共振
恢复率
cervical vertebra
spinal cord injury
early surgical treatment： magnetic resonance
recover）. rate
