脊髓线预测颈椎后路开门术后脊髓减压效果的临床研究

目的 探讨颈椎后路开门手术后脊髓减压程度的预测及方法.方法 收集2008年3月至2009年8月25例行颈椎单开门椎管成形术患者术前、术后的MRI图像.根据脊髓前方的压迫程度可分为0～4分;其中＞3分(3和4分)表明有脊髓压迫,＜3分表明脊髓无压迫.在开门节段上位椎体下终板做一水平线与脊髓前方成一交点,在开门节段下位椎体...

Prediction of spinal cord decompression after cervical laminoplasty: the SC-line

Objectives To report a new index (the SC-line) and a new classification for predicting of postoperative spinal cord decompression after cervical laminoplasty. Methods From March 2008 to August 2009, MRI images of 25 patients treated with cervical laminoplasty were retrospectively studied.Using T2-weighted images of the cervical spine, point A was anterior point of the spinal cord at inferior endplate level of cranial compressed vertebra. Point B was anterior point of the spinal cord at superior endplate level of caudal compressed vertebra. The SC-line was defined as a line that connects A and B.Posterior surface of compressor at compression level did not exceed the line in Type Ⅰ , connected the line in Type Ⅱ , and exceeded it in Type Ⅲ . Twenty-five patients who underwent cervical laminoplasty were classified into 3 groups according to the SC-line classification. The posterior shift of the spinal cord after the posterior decompression procedure was evaluated by using a modified gradation of degree of anterior spinal cord compression by MRI finding. The relationship between the degree of anterior spinal cord compression after surgery and the SC-line types were analyzed. Results Preoperative cervical SC-line classification showed high correlations to the degree of spinal cord decompression. There were 3. 82 ± 0. 39 points in Type Ⅰ before surgery, 3. 90 ±0. 32 points in Type Ⅱ , and 4. 00 ±0. 00 points in Type Ⅲ , respectively. After surgery, there were 1. 15 ±0. 50 points in Type Ⅰ , 2. 70 ±0. 48 points in Type Ⅱ , and 3. 50 ±0. 55 points in Type Ⅲ, respectively. Significant differences were found between each Type ( F = 42. 49, P ＜ 0. 01; Type Ⅰ vs. Type Ⅱ : P＜0. 01;Type Ⅰvs. Type Ⅲ: P ＜0. 01;Type Ⅱ vs. Type Ⅲ: P =0.038). Conclusion SC-line can be used to predict the degree of postoperative spinal cord decompression following cervical laminoplasty.