肌电图联合MRI判断脊髓型颈椎病预后的相关性分析

Correlation analysis between electromyogram combined with MRI and the curative effect of surgery for cervical spondylotic myelopathy

[目的]探讨肌电图联合MRI检测在评估脊髓型颈椎病患者手术疗效中的应用价值。[方法]选择经临床表现及影像学检查确诊为脊髓型颈椎病的患者,给予常规肌电图检查,选取其中肌电图检查排除合并腕管综合征、肘管综合征等周围神经病变的患者共89例,根据病情采用前路、后路或后前路联合手术,术后进行随访。按照肌电图检查结果与MRI T2WI是否存在高信号进行分类,即Ⅰ型:EMG/MRI为-/-,Ⅱ型:EMG/MRI为-/+,Ⅲ:EMG/MRI型为+/-,Ⅳ型:EMG/MRI为+/+。根据手术前后JOA分值计算临床改善率,进而将相关数据进行统计处理,分析彼此间的相关性。[结果]肌电图表现为I型36例、Ⅱ型17例、Ⅲ型10例、Ⅳ型26例,术后疗效优42例、良20例、可18例、差9例,各种类型与术后疗效的关系行秩和检验,结果显示:Hc=30.72,P<0.05,表明不同类型间术后疗效差异具有统计学意义。[结论]肌电图联合MRI检测类型与临床改善率间存在显著相关性,从而有助于更准确地预测手术效果。

[ Objective] To observe the correlation between electromyogram （EMG） combined with MRI and clinical outcome in patients with cervical spondylotic myelopathy （CSM） . [ Methods] Patients with CSM who were confirmed by clinical and image examination were examined by EMG. Peripheral nerve injury such as cubital tunnel syndrome and carp tunnelsyndrome were excluded. Eighty - nine cases were selected and followed - up after surgical treatment with anterior, posterior, or posterior - anterior combined surgery. Four types were classified according to EMG and MRI. Type Ⅰ ： EMG/MRI （ - / - ） . Type Ⅱ： EMG/MRI （-/＋） .Type Ⅲ： EMG/MRI （＋/-） .Type IV： EMG/MRI （＋/＋） .The cliniealoutcome were also graded according to the Japanese Orthopaedic Association （JOA） scoring system. Furthermore, the data were analyzed statistically to explore the correlation of the factors. [ Results ] The results showed that 36 cases were in Type Ⅰ , 17 were in Type Ⅱ, 10 were in Type m and 26 were in Type Ⅳ. Clinical function was excellent in 42 patients, good in 20 patients, fair in 18 patients, and poor in 9 patients. There was a good correlation between types and the clinical outcome （ Hc = 30. 72, P 〈 0. 05 ） . [ Conclusion] There＇ s a distinct correlation between EMG combined with MRI and the rate of clinical improvement in CSM patients. They are beneficial to the prognosticating of the outcome of CSM.