本文選題：脊髓型頸椎病　切入點(diǎn)：過(guò)伸過(guò)屈位MRI　出處：《中國(guó)煤炭工業(yè)醫(yī)學(xué)雜志》2016年12期

【摘要】：目的使用過(guò)伸過(guò)屈位MRI評(píng)估脊髓型頸椎病嚴(yán)重退變節(jié)段臨近節(jié)段穩(wěn)定性及脊髓壓迫程度的動(dòng)態(tài)改變,為評(píng)估病情提供參考。方法選取2014年7月—2016年7月哈爾濱醫(yī)科大學(xué)附屬第一醫(yī)院確診為脊髓型頸椎病且中立矢狀位MRI表現(xiàn)為Muhle分級(jí)2級(jí)以上的的患者95例,按照脊髓壓迫所在最重節(jié)段分為C3/C4(16例),C4/C5(27例),C5/C6(34例),C6/C7(18例)4組,再按照脊髓壓迫嚴(yán)重程度將病例分為2級(jí)組(31例),3級(jí)組(64例)均加拍過(guò)伸過(guò)屈位MRI片,并于所成MRI的T2矢狀位下,以脊髓壓迫加重病例數(shù)衡量評(píng)估退變節(jié)段頭尾端節(jié)段脊髓壓迫狀態(tài)的動(dòng)態(tài)變化,測(cè)量過(guò)伸過(guò)屈位下退變最嚴(yán)重節(jié)段臨近頭尾端各一個(gè)節(jié)段的椎間角位移,頸椎總體的角度位移,所測(cè)得角位移之和反映相應(yīng)節(jié)段及頸椎總體活動(dòng)功能,對(duì)于其節(jié)段穩(wěn)定性及脊髓壓迫程度的動(dòng)態(tài)變化進(jìn)行分析。結(jié)果頸椎總體活動(dòng)度為(28.31±4.66)°,(35.29±3.65)°,(32.81±4.43)°,(27.08±5.64)°,該節(jié)段活動(dòng)度為(9.96±5.78)°,(11.58±4.43)°,(7.08±2.69)°,(9.25±2.04)°,臨近頭端節(jié)段活動(dòng)度為(3.16±2.16)°,(8.41±4.98)°,(10.98±2.44)°,(5.53±3.25)°,臨近尾端節(jié)段活動(dòng)度為(5.31±3.62)°,(4.08±3.28)°,(8.52±2.04)°,(2.15±3.44)°,其中頸椎總體活動(dòng)度各組間差異無(wú)統(tǒng)計(jì)學(xué)意義,C5/6的本節(jié)段活動(dòng)度,臨近頭端節(jié)段活動(dòng)度以及臨近尾端節(jié)段活動(dòng)度同C3/4,C4/5以及C5/6組間差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。各組上下節(jié)段壓迫提升率同相應(yīng)節(jié)段活動(dòng)度間缺乏相關(guān)性。結(jié)論過(guò)伸過(guò)屈位MRI可用于脊髓型頸椎病明顯退變節(jié)段臨近節(jié)段功能的評(píng)估,嚴(yán)重退變所在節(jié)段同臨近節(jié)段功能變化有關(guān),C5/6節(jié)段在頸椎臨近節(jié)段退變過(guò)程中有重要意義。過(guò)伸過(guò)屈位MRI可用于脊髓型頸椎病明顯退變節(jié)段臨近節(jié)段功能的評(píng)估,嚴(yán)重退變所在節(jié)段同臨近節(jié)段功能變化有關(guān),C5/6節(jié)段在頸椎臨近節(jié)段退變過(guò)程中有重要意義。
[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 鹵4.66 擄~ 35.29 鹵3.65 擄~ (32.81 鹵4.43) 擄~ (27.08 鹵5.64) 擄~ (27.08 鹵5.64) 擄, the motion of this segment was 11.58 鹵4.43 擄~ (11.58 鹵4.43) 擄~ 9.08 鹵2.69 擄~ 9.25 鹵2.04 擄~ (9.25) 擄~ (9.25) 擄~ (9.25) 擄~ (9.25) 擄~ (9.25) 擄), the motion degree of adjacent segment was 3.16 鹵2.16 擄~ (8.41 鹵4.44) 擄~ (10.98 鹵2.44) 擄~ (5.53 鹵3.25) 擄), the motion degree of adjacent end segment was 5.31 鹵3.62 擄~ (4.08 鹵3.28) 擄鹵8.2.52 擄鹵2.42 擄鹵4.15 擄, and the total motion degree of cervical vertebrae was 3.16 鹵2.16 擄~ (8.41 鹵4.44) 擄~ (10.98 鹵2.44) 擄~ (5.53 鹵3.25) 擄). 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.
【作者單位】： 哈爾濱醫(yī)科大學(xué)附屬第一醫(yī)院骨科;
【分類號(hào)】：R681.5;R445.2
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本文編號(hào)：1690295