Preoperative Conventional MRI+Cervical Sagittal Plane Parameters in Predicting the Prognosis of Cervical Radiculopathy after Surgery and Analysis of Its Guiding Significance for Surgical Treatment
Objective To analyze the value of preoperative routine MRI+cervical sagittal plane parameters in predicting postoperative outcome of cervical radiculopathy and its guiding significance for surgical treatment,so as to provide reference for making targeted intervention programs in early clinical stage.Methods 249 patients with radicular cervical spondylosis admitted to our hospital from January 2020 to June 2022 were selected and divided into good group(n=211,JOA improvement rate＞50％)and bad group(n=38,JOA improvement rate＜50％)according to the improvement rate of Japanese Orthopaedic Association(JOA)6 months after surgery.Preoperative conventional MRI+cervical sagittal plane parameters(number of involved segments,spinal edema/degeneration,C2-7 Cobb Angle,C1-7 sagittal plane axial distance(SVA),C2-7 SVA,T1)were compared between the two groups Inclination Angle(T1S),width of foraminal,difference between inclination Angle of T1 and lordosis Angle of cervical spine(T1s-CI),segmental lordosis(SL)],Pearson analyzed the relationship between C2-7 Cobb Angle,T1S,width of foraminal,T1S-Cl and JOA score 6 months after surgery,and partial correlation analysis of factors related to JOA score 6 months after surgery.Receiver operating characteristic curve(ROC)was used to analyze the predictive value of preoperative conventional MRI+cervical sagittal plane parameters for postoperative outcomes.Results The proportion of patients with spinal edema/degeneration,T1S and T1s-Cl in poor group were higher than those in good group,and the C2-7 Cobb Angle and the width of foramina in poor group were lower than those in good group(P＜0.05).T1S and T1s-Cl were negatively correlated with JOA score 6 months after surgery,and C2-7 Cobb Angle and foraminal width were positively correlated with JOA score 6 months after surgery(P＜0.05).Partial correlation analysis showed that spinal cord edema/degeneration,C2-7 Cobb Angle,T1S,foraminal width,t1s-Cl were correlated with JOA score 6 months after surgery(P＜0.05).Spinal cord edema/degeneration,C2-7 Cobb Angle,T1S,foraminal width,and T1S-Cl predicted the outcome AUC of the disease to be 0.647,0.797,0.802,0.767,and 0.750,respectively.The combined prediction AUC was 0.913,sensitivity 94.74％,and specificity 78.67％.Condusion Preoperative conventional MRI+cervical sagittal plane parameters can be used to predict and evaluate the postoperative prognosis of cervical radiculopathy,which can be used in the clinical development of preoperative surgical plan to improve the postoperative prognosis.
MRICervical Sagittal Plane ParametersRadiculopathySurgical TreatmentDisease OutcomePredictive Value
NETL
NSTL
万方数据
维普
