脊髓型颈椎病的影像学危险因素分析

发布时间：2018-01-19 14:26

本文关键词： 脊髓型颈椎病脊髓压迫危险因素　出处：《广东医学》2017年22期 　论文类型：期刊论文

【摘要】：目的寻找脊髓型颈椎病(CSM)发病的影像学危险因素。方法回顾性纳入无症状颈椎退变性脊髓压迫(A-SCCC)患者和CSM患者各69例。分别观察、测量两组的影像学因素:颈椎稳定性、脊髓高信号、脊髓受压迫类型、压迫程度、压迫节段数目、发育性椎管狭窄,并进行多因素分析。结果两组患者年龄差异无统计学意义(P=0.78)。在138例患者中,发育性颈椎管狭窄32例;颈椎失稳50例;脊髓受压迫1个节段、2个节段及3个节段或以上的各有81、37和20例;脊髓受压迫最严重节段C_(3/4)、C_(4/5)、C_(5/6)、C_(6/7)分别有18、35、66和19例;脊髓压迫率方面,A-SCCC组平均压迫率为0.27±0.066,CSM组平均压迫率为0.26±0.072;脊髓压迫物类型方面,单纯椎间盘突出有101例,骨化有12例,混合型有25例;61例患者在MRI上可见T2WI高信号。分别统计两组数据,logistic回归分析结果提示,CSM的可能危险因素分别是颈椎不稳、脊髓压迫物类型、T2WI高信号,其回归系数分别为-1.043、1.837和-2.902,OR值分别为0.353、6.276、0.055,其中无颈椎不稳和无脊髓高信号为保护因素(常数项0)。结论 CSM患者,以中老年人多见,无性别差异。其发病节段最多见于C_(5/6)节段和C_(4/5)节段,且与颈椎稳定性、脊髓高信号、受压迫类型等危险因素相关,与压迫程度、发育性椎管狭窄、压迫节段数目无相关性。
[Abstract]:Objective to investigate the imaging risk factors of CSM in cervical Spondylotic myelopathy (CSM). Methods A SCCC was retrospectively included in asymptomatic cervical degenerative spinal cord compression. 69 patients and 69 patients with CSM were observed. The imaging factors of the two groups were measured: cervical spine stability, spinal cord hyperintensity, type of compression of spinal cord, degree of compression, number of compression segments, and developmental spinal stenosis. Results there was no significant difference in age between the two groups (P = 0.78). Among 138 patients, 32 had developmental stenosis of cervical spinal canal. Cervical spine instability in 50 cases; The spinal cord was compressed in 1 segment, 2 segments and 3 segments or more in 81, 37 and 20 cases, respectively. The most severely compressed segments of the spinal cord were: 3 / 4 / 4 / 10 / 5 / 5 / 5 / 5 / 6 / 7) of 1 835 / 66 and 19 / 7 respectively; The average compression rate of CSM group was 0.26 卤0.072; There were 101 cases of disc herniation, 12 cases of ossification and 25 cases of mixed type. High T2WI signal intensity was observed on MRI in 61 patients. Logistic regression analysis showed that the possible risk factor of CSM was cervical instability. The type of spinal cord compression was hyperintense on T _ 2WI, the regression coefficients were -1.043 ~ 1.837 and -2.902U _ (OR) were 0.353 ~ 6.276 ~ 0.055, respectively. No cervical instability and no hyperintense spinal cord were the protective factors (constant term 0). Conclusion CSM is more common in the middle-aged and the elderly. There was no sex difference. The most common segment of the disease was in the 5 / 6 segment of C / T and 4 / 5 / 5 of C / T, and was related to the stability of cervical spine, high signal intensity of spinal cord, type of compression and other risk factors, and was related to the degree of compression. There was no correlation between the number of compression segments and the number of developmental spinal stenosis.
【作者单位】：广东省中医院骨一科(脊柱专科);
【基金】：广东省财政厅中医(民族医)药专项资助项目(编号:2100601)
【分类号】：R681.55
【正文快照】： 脊髓型颈椎病(cervical spondylotic myelopathy,CSM)是导致脊髓功能障碍最常见的疾病。颈脊髓受压可导致CSM的发生,但在临床上我们观察到部分中老年人患者存在椎体后方组织压迫脊髓的影像学征象,而其却没有脊髓受压迫损害的症状表现。党耕町等[1]将这种无症状压迫状态(asympt

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