| 影响脊髓型颈椎病远期预后的相关因素分析 |
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Received:February 07, 2007
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| 作者 | Author | 单位 | Unit | E-Mail |
| 苗胜 |
MIAO Sheng |
徐州医学院附属医院骨科,江苏徐州221002 |
Department of Orthopaedics,the Affiliated Hospital of Xuzhou Medical College,Xuzhou 221002,Jiangsu,China |
miaosheng@126.com |
| 龚维成 |
GONG Wei-cheng |
徐州医学院附属医院骨科,江苏徐州221002 |
Department of Orthopaedics,the Affiliated Hospital of Xuzhou Medical College,Xuzhou 221002,Jiangsu,China |
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| 秦宏铭 |
QIN Hong-min |
徐州医学院附属医院骨科,江苏徐州221002 |
Department of Orthopaedics,the Affiliated Hospital of Xuzhou Medical College,Xuzhou 221002,Jiangsu,China |
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| 李强 |
LI Qiang |
徐州医学院附属医院骨科,江苏徐州221002 |
Department of Orthopaedics,the Affiliated Hospital of Xuzhou Medical College,Xuzhou 221002,Jiangsu,China |
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| 胡东 |
HU Dong |
徐州医学院附属医院骨科,江苏徐州221002 |
Department of Orthopaedics,the Affiliated Hospital of Xuzhou Medical College,Xuzhou 221002,Jiangsu,China |
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| 期刊信息：《中国骨伤》2007年20卷，第10期，第666-668页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:探讨年龄、病程、MRI(脊髓受压程度、髓内信号)和皮层体感诱发电位(cortical somatosensory e-voked potential,CSEP)变化对脊髓型颈椎病(cervical spondylotic myelopathy,CSM)手术预后的影响。
方法:选择颈前路减压植骨整合钛制带锁螺钉钢板固定治疗的28例CSM患者进行回顾性分析。年龄35～71岁,平均49.6岁;病程4个月～2年,平均18个月。分别依患者的年龄、病程、MRI(脊髓受压程度及有无信号异常)和CSEP等因素进行分组,根据日本矫形外科学会(JOA)制定的脊髓功能评分标准评价患者术后脊髓功能状态,分析各因素与脊髓型颈椎病手术预后的关系。
结果:随访1.5～3年,平均2.3年。年龄>60岁与年龄≤60岁术后JOA评分差异有统计学意义(P<0.05),病程>6个月与病程≤6个月术后JOA评分差异有统计学意义(P<0.05),脊髓受压<1/3与脊髓受压≥1/3者术后JOA评分差异有统计学意义(P<0.05),MRIT2加权像和T1加权像信号正常者与T2加权像高信号者术后JOA评分差异有统计学意义(P<0.05),T2加权像高信号、T1加权像信号正常者与T2加权像高信号伴T1加权像信号减弱者术后JOA评分差异有统计学意义(P<0.01),CSEP正常者与异常者术后JOA评分差异无统计学意义(P>0.05)。
结论:观察患者的年龄、病程、脊髓受压程度、髓内有无信号异常有助于预测CSM脊髓功能的预后,而不能仅依CSEP判断脊髓的功能状态。 |
| [关键词]:脊髓型颈椎病 减压 磁共振成像 皮层体感诱发电位 |
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| Correlative factor analysis on the long-term prognosis of cervical spondylotic myelopathy |
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Abstract:
Objective:To explore the relation among age,course of disease,MRI(the signal and degree of spinal cord compression),cortical somatosensory evoked potential(CSEP)and the long-term prognosis of cervical spondylotic myelopathy(CSM).
Methods:Twenty-eight patients with CSM(age from 35 to 71 years old with an average of 49.6 years and the courses of disease from 4 months to 2 years with an average of 18 months) were analyzed retrospectively.The functional status of spinal cords was evaluated according to Japanese Orthopaedic Association(JOA) scoring criteria.Through the comparison between the postoperative outcomes and collected data(the age,course of disease,MRI,CSEP),analyzed the relationship between the factors and the prognosis.
Results:Following-up was from 1.5 to 3 years with an average of 2.3 years.There was significant difference of JOA score between two age groups(>60 years and ≤60 years)(P<0.05)and two course groups(>6 months,≤6 months)(P<0.05);the compression district of spinal cord less than 1/3 and not less than 1/3(P<0.05);normal signal of MRI T1WI,MRI T2WI and simple high signal of MRI T2WI(P<0.05);simple high signal of MRI T2WI and high signal of MRI T2WI accompany with low signal of T1WI(P<0.05).There was no significant difference of JOA score between normal CSEP and abnormal CSEP(P>0.05).
Conclusion:Observing age,the course of disease,degree of spinal cord compression,signal changes in MRI could help to predict the prognosis of cervical spondylotic myelopathy.CSEP can not be used to evaluate the functional status of spine cord. |
| KEYWORDS:Cervical spondylotic myelopathy Decompression Magnetic resonance imaging Cortical somatosensory evoked potential |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 苗胜,龚维成,秦宏铭,李强,胡东.影响脊髓型颈椎病远期预后的相关因素分析[J].中国骨伤,2007,20(10):666~668 |
| 英文格式: | MIAO Sheng,GONG Wei-cheng,QIN Hong-min,LI Qiang,HU Dong.Correlative factor analysis on the long-term prognosis of cervical spondylotic myelopathy[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(10):666~668 |
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