有效颈椎管率、颈椎管率对退行性腰椎侧凸症、脊髓型颈椎病的诊断价值

目的 探讨有效颈椎管率、颈椎管率对退行性腰椎侧凸症(DLS)、脊髓型颈椎病(CSM)的诊断价值.方法 选择100例患者,根据影像学检查及结合临床(金标准)诊断结果,分为DLS患者和非DLS患者各50例,CSM患者52例和非CSM患者48例.测量所有患者C6椎体的有效颈椎管率和颈椎管率,并采用受试者工作特征(ROC)曲线分析有效颈椎管率和颈椎管率诊断DLS、CSM的价值.结果 DLS患者的有效颈椎管率低于非DLS患者(P<0.05),但两者的颈椎管率比较,差异无统计学意义(P>0.05);CSM患者的有效颈椎管率、颈椎管率低于非CSM患者(P<0.05).ROC曲线分析结果显示,有效颈椎管率、颈椎管率诊断DLS的曲线下面积分别为0.648、0.612(P>0.05),敏感性分别为62.0%、64.0%,特异性分别为58.0%、52.0%;有效颈椎管率、颈椎管率诊断CSM的曲线下面积分别为0.858、0.836(P>0.05),敏感性分别为82.7%、67.3%,特异性分别为79.2%、83.3%.结论 有效颈椎管率、颈椎管率均对CSM有一定的诊断价值,且两者效果相当,但二者均对DLS的诊断价值不高.

Value of effective cervical spinal canal ratio and cervical spinal canal ratio in diagnosis of degenerative lumbar scoliosis and cervical spondylotic myelopathy

Objective To explore the value of effective cervical spinal canal ratio(ECSCR) and cervical spinal canal ratio(CSCR) in diagnosing degenerative lumbar scoliosis(DLS) and cervical spondylotic myelopathy(CSM).Methods According to diagnostic results based on imaging and clinical examination (gold standard),one hundred patients were selected and were divided into 50 patients with DLS and 50 patients without DLS,or 52 patients with CSM and 48 patients without CSM.The ECSCR and CSCR of vertebrae C6 were measured in all patients.Receiver operating characteristic(ROC) curve was used to analyze the value of ECSCR and CSCR in diagnosing DLS and CSM.Results The ECSCR in patients with DLS was lower than that in patients without DLS(P<0.05),and there was no significant difference in the CSCR between the two groups(P>0.05).The ECSCR and CSCR in patients with CSM were lower than those in patients without CSM(P<0.05).The result of ROC curve analysis showed that the areas under the curve of ECSCR and CSCR in diagnosing DLS were 0.648 and 0.612 respectively(P>0.05),the sensitivities were 62.0% and 64.0% respectively,and the specificities were 58.0% and 52.0% respectively;the areas under the curve of ECSCR and CSCR in diagnosing CSM were 0.858 and 0.836 respectively(P>0.05),the sensitivities were 82.7% and 67.3% respectively,and the specificities were 79.2% and 83.3% respectively.Conclusion ECSCR and CSCR,with similar effects,have a certain value in the diagnosis of CSM.But neither of them achieve favorable value in the diagnosis of DLS.