The Clinical Analysis Of The Scoring System In The Nerve Function And The Factors Of The Prognosis In The Spinal Canal Tumor Surgery

Objective:Observed the nerve function change in preoperative and postoperation situation and analyzed the influence factors of prognosisin in intra-spinal canal tumor patients.This study was to analyze40cases of intra-spinal canal tumors surgical cases in our department since2008.6to2011.3.it was based on the patient’s follow-up and the clinical data from medical records and compared reliability the MC, IJOA, EMS scoring systems and analyzed the factors of the prognosis in spinal canal tumor patients.Method:Collected clinical data and postoperative follow-up of spinal canal tumor patients in our department since2008.6to2011.3and retrospectively analyzed.1.The nerve function scoring systems were IJOA, MC, EMS scoring systems of preoperative and postoperative scores.It was compared the three scoring systems, and analyzed that who was the best reliability. The nerve function systems were shown in the table (1-4).2.Based on the gender, age, duration time,The segment of tumor section,pathology,the relation between the spinal cord and tumor, preoperative neurological function scores and the change of scores,It was analyzed the single factor, multiple factors and correlation, and worked out the influence factors of prognosis. All using the SPSS17.0statistical analysis software for analysis.Results:(1) The compare of the MC, EMS,IJOA scoring system:1.Based on40cases by correlation analysis,It was analyzed that the correlation between the preoperative MC grading, postoperative MC grading and MC classification improvement and IJOA score, its improved value was much intensity correlation than the correlation between the preoperative MC grading, postoperative MC grading and MC classification improvement and EMS score, its improved value.2.It was compared with the nerve function scoring systems in thoracic segment between the lumbar segments.It was analyzed that the correlation between the preoperative MC classification and preoperative EMS was greater than the correlation between preoperative IJOA score in thoracic segment and Lumbar segment. It was analyzed that the correlation between MC classification improvement and IJOA score improved value is greater than the correlation between MC classification improvement and EMS improved value.(2) The analysis of various clinical factors in the prognosis:1. It was that the correlation analysis of multiple clinical factors between the postoperative neurological function score and improved value.The analysis of the correlation between postoperative neurological function score and preoperative factors was that the preoperative neurological function score was positively correlated with postoperative neurological function score.The analysis of the correlation between the relationship between the tumor and spinal cored,the course of time and the postoperative neurological function score were negative correlation.the stronger correlation was the relationship between the tumor and spinal cored.The analysis of the correlation between the nerve function Improved value, the preoperative neurological function score and the postoperative neurological function score were negative correlation It was showed the relationship between the neurological function improved value and the various preoperative clinical factors by the multiple linear regression analysis. The lower preoperative neurologic function score, younger, the postoperative neurological function improved value was greater.The larger place between the spinal cord and the tumor,the postoperative neurological function improved value was larger.Conclusion:1.In the absence of serious severe neurologic damage cases,the possibility of the reliability in the IJOA scoring system is superior than in the EMS score system.2. In the Severe neurological damage cases, the possibility of the reliability in the EMS scoring system is better than in the IJOA scoring system.The larger place between the spinal cord and the tumor,the shorter time of duration, the higher preoperative neurologic function score,the prognosis was better.The lower preoperative neurologic function score,younger,the larger place between the spinal cord and the tumor,the postoperative neurological function improved value was larger and the prognosis was better.