颈椎动力位MRI在脊髓型颈椎病诊治中的作用

Effect of cervical kinematic MRI in diagnosis and treatment of cervical spondylotic myelopathy

目的探讨颈椎动力位MRI在脊髓型颈椎病诊治中的作用。方法分别测量42例患者共59节病变节段在颈椎过屈、中立、过伸位时的硬膜囊中矢径与脊髓中矢径,对比两者在不同体位下的变化。结果 59节病变节段,在过屈、中立、过伸位时,测出平均硬膜囊中矢径分别是:(7.63±0.90)mm,(6.48±0.82)mm,(5.85±0.89)mm;平均脊髓中矢径分别是:(6.44±0.80)mm,(5.81±0.82)mm,(5.56±0.82)mm。在过伸位时,硬膜囊中矢径与脊髓中矢径之间差值最小(0.29±0.60)mm(P<0.01),脊髓代偿空间最小。结论在脊髓型患者中,颈椎病动力位MRI可以显示脊髓在不同体位下动态受压变化,对其治疗方式的选择有极大帮助。

Objective To investigate the use of the cervical kinematic MRI in the diagnosis and treatment of cervical spondylotic myelopathy .Methods The sagittal diameter of dural sac and spinal cord in the 42 cases with total 59 le-sions segments , were measured in the over flexion , neutral and hyperextension position respectively , and the changes in different positions were evaluated .Results In the 59 lesions segments , the average sagittal diameter of dural sac was （7.63 ±0.90） mm,（6.48 ±0.82） mm,（5.85 ±0.89） mm respectively in the over flexion, neutral and hyper-extension position.And the average sagittal diameter of spinal cord was （6.44 ±0.80） mm,（5.81 ±0.82） mm, （5.56 ±0.82） mm respectively in three different positions .The minimum difference （0.29 ±0.60） mm between vectors of dural sac and spinal cord was in the extension position with a minimal spinal cord reserve space （ P 〈0.01）.Conclusions In the cervical spondylotic myelopathy , cervical kinematic MRI can indicate the dynamic spi-nal cord compression in the different positions , and be useful in treatment .