过伸过屈位MRI评估脊髓型颈椎病退变临近节段功能

发布时间：2018-03-31 10:16

  本文选题：脊髓型颈椎病　切入点：过伸过屈位MRI　出处：《中国煤炭工业医学杂志》2016年12期

【摘要】：目的使用过伸过屈位MRI评估脊髓型颈椎病严重退变节段临近节段稳定性及脊髓压迫程度的动态改变,为评估病情提供参考。方法选取2014年7月—2016年7月哈尔滨医科大学附属第一医院确诊为脊髓型颈椎病且中立矢状位MRI表现为Muhle分级2级以上的的患者95例,按照脊髓压迫所在最重节段分为C3/C4(16例),C4/C5(27例),C5/C6(34例),C6/C7(18例)4组,再按照脊髓压迫严重程度将病例分为2级组(31例),3级组(64例)均加拍过伸过屈位MRI片,并于所成MRI的T2矢状位下,以脊髓压迫加重病例数衡量评估退变节段头尾端节段脊髓压迫状态的动态变化,测量过伸过屈位下退变最严重节段临近头尾端各一个节段的椎间角位移,颈椎总体的角度位移,所测得角位移之和反映相应节段及颈椎总体活动功能,对于其节段稳定性及脊髓压迫程度的动态变化进行分析。结果颈椎总体活动度为(28.31±4.66)°,(35.29±3.65)°,(32.81±4.43)°,(27.08±5.64)°,该节段活动度为(9.96±5.78)°,(11.58±4.43)°,(7.08±2.69)°,(9.25±2.04)°,临近头端节段活动度为(3.16±2.16)°,(8.41±4.98)°,(10.98±2.44)°,(5.53±3.25)°,临近尾端节段活动度为(5.31±3.62)°,(4.08±3.28)°,(8.52±2.04)°,(2.15±3.44)°,其中颈椎总体活动度各组间差异无统计学意义,C5/6的本节段活动度,临近头端节段活动度以及临近尾端节段活动度同C3/4,C4/5以及C5/6组间差异均有统计学意义(P0.05)。各组上下节段压迫提升率同相应节段活动度间缺乏相关性。结论过伸过屈位MRI可用于脊髓型颈椎病明显退变节段临近节段功能的评估,严重退变所在节段同临近节段功能变化有关,C5/6节段在颈椎临近节段退变过程中有重要意义。过伸过屈位MRI可用于脊髓型颈椎病明显退变节段临近节段功能的评估,严重退变所在节段同临近节段功能变化有关,C5/6节段在颈椎临近节段退变过程中有重要意义。
[Abstract]:Objective to evaluate the dynamic changes of the stability of the adjacent segment of severe cervical spondylosis and the degree of spinal cord compression by MRI. Methods from July 2014 to July 2016, 95 patients with cervical Spondylotic myelopathy diagnosed in the first affiliated Hospital of Harbin Medical University and presented with neutral sagittal MRI above Muhle grade 2 were selected. According to the most severe segment of spinal cord compression, 27 cases of C3/C4(16 were divided into 4 groups with 34 cases of C 5 / C 6 and 34 cases with C 6 / C 7 and 18 cases with spinal cord compression. According to the severity of spinal cord compression, the cases were divided into group 2 (n = 31, n = 64) with extension and flexion MRI film, and under T 2 sagittal position of MRI. The dynamic changes of spinal cord compression were evaluated in terms of the number of cases with aggravated spinal cord compression. The intervertebral angular displacement and the total angular displacement of cervical vertebrae were measured in the most severe degenerative segment in the position of extension, flexion and flexion, one segment adjacent to the end of the head, and the total angle displacement of the cervical vertebrae. The sum of the measured angular displacements reflects the corresponding segment and the overall motion function of the cervical vertebrae. Results the total motion of cervical vertebrae was 28.31 卤4.66 掳~ 35.29 卤3.65 掳~ (32.81 卤4.43) 掳~ (27.08 卤5.64) 掳~ (27.08 卤5.64) 掳, the motion of this segment was 11.58 卤4.43 掳~ (11.58 卤4.43) 掳~ 9.08 卤2.69 掳~ 9.25 卤2.04 掳~ (9.25) 掳~ (9.25) 掳~ (9.25) 掳~ (9.25) 掳~ (9.25) 掳), the motion degree of adjacent segment was 3.16 卤2.16 掳~ (8.41 卤4.44) 掳~ (10.98 卤2.44) 掳~ (5.53 卤3.25) 掳), the motion degree of adjacent end segment was 5.31 卤3.62 掳~ (4.08 卤3.28) 掳卤8.2.52 掳卤2.42 掳卤4.15 掳, and the total motion degree of cervical vertebrae was 3.16 卤2.16 掳~ (8.41 卤4.44) 掳~ (10.98 卤2.44) 掳~ (5.53 卤3.25) 掳). There was no statistically significant difference in total activity between groups and the current segment activity of C5 / 6. There was significant difference between the motion of proximal cephalic segment and that of adjacent tail end segment with C3 / 4, C4 / 5 and C5 / 6 groups (P < 0.05). There was no correlation between the compression and lifting rate of upper and lower segments in each group and the corresponding segmental motion. Conclusion there is no correlation between hyperextension and flexion. MRI can be used to evaluate the function of adjacent segments of cervical Spondylotic myelopathy. The level of severe degeneration is related to the functional changes of adjacent segments. MRI can be used to evaluate the function of adjacent segments of cervical Spondylotic myelopathy. The segment of severe degeneration is related to the functional changes of adjacent segments. The C5 / 6 segment plays an important role in the process of cervical vertebrae proximal degeneration.
【作者单位】： 哈尔滨医科大学附属第一医院骨科;
【分类号】：R681.5;R445.2
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本文编号：1690295