MRI下颈长肌容积测量在脊髓型颈椎病患者ACDF术后疗效预测中的意义
The significance of measuring the volume of the cervical longus muscle under MRI in predicting the postoperative effi-cacy of ACDF in patients with cervical spondylotic myelopathy
殷凯卫 1赵兴 2陈叶海 3杨俊涛 3周冰4
作者信息
- 1. 浙江省东阳花园田氏医院脊柱外科 浙江 金华 322105;浙江大学附属邵逸夫医院脊柱外科 浙江 杭州 310000
- 2. 浙江省东阳花园田氏医院脊柱外科 浙江 金华 322105
- 3. 浙江大学附属邵逸夫医院脊柱外科 浙江 杭州 310000
- 4. 浙江省湖州市中心医院医学影像科 浙江 湖州 313000
- 折叠
摘要
目的 探讨磁共振成像(MRI)下颈长肌容积测量在脊髓型颈椎病(CSM)患者颈椎前路椎间盘切除融合术(ACDF)术后疗效预测中的应用价值.方法 选取本院接受ACDF治疗的 68 例CSM患者的临床资料.所有患者均在手术前进行MRI检查,测量手术节段相对应的颈长肌肌肉截面积和层厚,计算患者的颈长肌容积,分析颈长肌容积预测术后疗效的价值.结果 68 例患者手术疗效优秀 38 例(为手术疗效优秀组),占 55.88%(38/68),30 例患者手术疗效良好(为手术疗效良好组),占 44.12%(30/68);手术疗效优秀组术前颈长肌容积低于手术疗效良好组,术后 15 个月视觉模拟评分法(VAS)评分、颈部功能障碍指数(NDI)均低于手术疗效良好组,改良日本骨科协会评分(mJOA)高于手术疗效良好组,差异均有统计学意义(P<0.05);经双变量Pearson相关性分析,CSM患者ACDF术前颈长肌容积分别与VAS评分、NDI评分呈负相关关系(r=-0.482、-0.377,P<0.05),与mJOA评分无相关性(P>0.05);CSM患者ACDF术前颈长肌容积预测术后疗效的灵敏度为 86.70%,特异度为 78.90%,曲线下面积(AUC)为 0.902,截断值为 8525.70 mm3.结论 CSM患者ACDF术前颈长肌容积对术后疗效有一定预测价值,且其大小与VAS评分、NDI指数均呈负相关关系.
Abstract
Objective To analyze the application value of magnetic resonance functional imaging(MRI)in measuring the vol-ume of the cervical longus muscle in predicting the postoperative efficacy of anterior cervical discectomy and fusion(ACDF)in pa-tients with cervical spondylotic myelopathy(CSM).Methods Clinical data of 68 CSM patients who received ACDF treatment were retrospectively collected.All patients underwent MRI examination before surgery to measure the cross-sectional area and layer thickness of the cervical longus muscle corresponding to the surgical segment,and to calculate the volume of the cervical longus muscle.And then,we analyzed the value of predicting postoperative efficacy by analyzing the volume of the cervical longus muscle.Results The surgical efficacy of 68 patients was excellent in 38 cases,accounting for 55.88%(38/68),and the other 30 patients had good surgical efficacy,accounting for 44.12%(30/68);the volume of longus colli muscle before operation in the excel-lent surgical efficacy group was lower than that in the good surgical efficacy group.The visual analogue scale(VAS)score and neck dysfunction index(NDI)at 15 months after operation were lower than those in the good surgical efficacy group,and the modified Japanese Orthopaedic Association score(mJOA)was higher than that in the good surgical efficacy group,with statistical signifi-cant differences(P<0.05).By bivariate Pearson correlation analysis,the volume of longus colli in CSM patients before ACDF was negatively correlated with VAS score and NDI score(r=-480,-0.377,P<0.05),but not with mJOA score(P>0.05).The sensitiv-ity,specificity,area under the curve and cut-off value of cervical longus muscle volume before ACDF in CSM patients were 86.70%,78.90%,0.902 and 8525.70 mm3,respectively.Conclusion The volume of longus colli in CSM patients before ACDF has a certain predictive value for postoperative efficacy,and its size is negatively correlated with VAS score and NDI index.
关键词
磁共振成像/颈长肌容积/脊髓型颈椎病/颈椎前路椎间盘切除融合术Key words
Magnetic resonance imaging/Cervical longus muscle volume/Cervical spondylotic myelopathy/Anterior cervi-cal discectomy and fusion引用本文复制引用
基金项目
浙江省基础公益研究计划项目(LGF21G010025)
出版年
2024
NETL
NSTL
万方数据