影响慢性压迫性颈脊髓病手术疗效的因素分析

对６６例慢性压迫性颈脊髓病患者的颈椎ＣＴＭ采用图像分析系统进行了测量研究。发现脊髓受压最重部位的脊髓横断面积（髓断面）、髓断面／椎管横断面积（管断面）比值及髓断面／椎体横断面积 （椎断面）与手术疗效密切相关。若髓断面积小于３０ｍｍ２，伴有髓断面／管断面比值＜０．２及髓断面／椎断面比值＜０．０８时，术后疗效不佳，脊髓功能有不可逆性改变的倾向。除病程、脊髓受压节段数及脊髓矢径／横径之比值等因素外，髓断面、髓断面／管断面及髓断面／推断面的比值三者是预测疗效的最可靠指标。

An analysis of the factors affecting surgical results of chronic compression cervical myelopathy (66 csaes measurement with CTM)

The morphometry of the spinal cord on CTM film in 66 patients with cervial compression myelopathy was studied by means of imaging analysis system. The results showed that the spinal cord cross-sectional area, the ratios of spinal cord cross-sectional area to the spinal canal cross-sectional area and to the spinal vertebral cross-sectional area at the site of maximum compression were correlated significantly with the results of surgery. In most patients with less than 30mm2 of the spinal cord area, the ratios of the spinal cord area to the spinal canal area less than 0. 2 and the ratios of the spinal cord area to the spinal ver- tebral area to the spinal vertebral area less than 0. 08, poor results were noted after ape- ration, and the cord function trended toward irreversibility of disease, levels of involvment and the ratios of the cord sagittal to transverse diameter affected the results of surgery. The spinal cord area, the ratios of the spinal cord area to spinal canal area and the ratios of the spinal cord area to spinal vertebral area were the most reliable and useful index in predicting the results of surgery.