The Correlation Among Prevertebral Hyperintensity Signal And Canal Sagittal Diameter On MRI With The Prognosis In Adult Patients With CSCIWORA

Type Cervical cord injury without fracture dislocation(Cervical spinal cord i njury without fracture and dislocation)on the international unified naming the Ce rvical cord injury without radiographic imaging abnormalities(Cervical spinal cor d injury without radiographic abnormality,CSCIWORA)is a special type of spin al cord injury,especially the neck after trauma,after the inspection methods such as X-ray,CT,Cervical vertebra not found obvious fracture or dislocation of a c linical common disease,37% ~ 52% of Cervical spinal injury.The disease in ad ults,because prior cervical vertebra base lesions,such as cervical stenosis to rese rve space reduce,bulging disc or prominent,and the longitudinal ligament calcifi cation(Ossification of posterior longitudinal ligament,OPLL)such lesions,even slight external force can cause cervical spinal injury,especially after cervical exc essive stretch and buckling,narrow vertebral canal sagittal diameter,intervertebral disc herniation is aggravating,and yellow ligament creases to highlight intra-spi nal canal can cause compression of the spinal cord,clinical symptoms.Because of the characteristic of the symptoms of CSCIWORA secretiveness and hysteresis,the missed diagnosis is high,and the X-ray,CT has no positive performance,c an be found only by MRI cervical spinal injury,the relatively high,so for the c linician’s technique if not timely diagnosis or treatment may not when,can have serious consequences.CSCIWORA cause there is still no research thorough,mo st thought is the result of joint action of many factors,the most direct injury fa ctors for fall,falling injury and accident injury,their common ground is head an d neck by external.At present the treatment most scholars also views,lack of t heoretical basis,this paper applied related criteria and statistical methods to provi de certain theoretical basis for the treatment for clinical CSCIWORA treatment n eeded help.Objective: to explore the adult patients with cervical spinal cord injury with out fracture dislocation before MRI vertebral high signal,vertebral canal sagittal diameter and the correlation of nerve function.This study aimed to have surgery CSCIWORA grouping patients according to the MRI signal before job,at the ti me of admission,one month after discharge,three months,six months and 12 m onths function score comparison results of the application of statistical methods f or processing,thus the correlation of MRI signal before vertebral and neural fun ction.Methods: a retrospective analysis from January 2010 to December 6 cases o f patients with cervical spinal cord injury without fracture dislocation of the data of 80 cases,according to former MRIT2 sequences vertebral high signal is divi ded into vertebral high signal group and no job before the high signal groups,39 cases of vertebral high signal before group,(31 male and 8 female,aged 21 t o 83,the average age(58.10 + 14.78);No vertebral high signal before the grou p of 41 cases,male 29 cases,12 cases were female,age 32 ~ 77 years old,av erage(55.05-10.36).Sagittal measurements by magnetic resonance imaging(MRI)in the middle of the cervical vertebral canal sagittal diameter,the intervertebral disc level and record the age,gender,cause of injury and spinal canal stenosis s egment number;By American Spinal Injury Association(American Spinal Injury Association,ASIA)and neurological function classification and JOA score to eva luate neural function.Application Japanese orthopaedic society(JOA)score stand ard for all the cases in the admission and discharge,three months,six months a nd 12 months when marking and respectively calculate the JOA rises,application of two independent sample t test and compared the results;Then the applicatio n of the international Association of Spinal cord Injury(American Spinal Injury Association,ASIA)neural classification standard at the time of admission,one m onth after discharge,three months,six months and 12 months follow-up function evaluation,application of rank and inspection,to analyze the results.Results: the results using statistical software SPSS17.0 analysis,measurement data with X + S.For vertebral high signal group and no job before the high si gnal line group JOA evaluation before and after the treatment respectively two in dependent samples t test,P > 0.05 admission()there were no significant differe nce,P < 0.1;discharge Three months(P < 0.05;Six months(P < 0.05(there ar e significant differences).Before application of two independent samples t test re spectively for vertebral high signal set is on admission and discharge,three mont hs,six months,12 months JOA score rises before with no vertebral high signal on admission,the hospital for a month,three months,six months,12 months JO A score rises,the results(P < 0.05,there are significant differences).ASIA nerv e to evaluate classification standard,in six months follow-up,admission and disc harge and the recovery of neurological function in hierarchies,and apply the Ma nn-Whitney U rank and inspection,six months after discharge,P < 0.05,with statistical significance.ASIA sports score before vertebral high signal group was52.56 + /-31.97,no job before high signal group was 67.70 +/-22.83,differences between the two groups was statistically significant(P = 0.013).Vertebral h igh signal before the group of patients with intramedullary high signal rate is sig nificantly higher than no job before high signal group(P = 0.006);ASIA sports score two groups of patients with injury of segmental vertebral canal sagittal dia meter disc level exists positive correlation(P = 0.003),and cervical stenosis seg ment,the more ASIA classification the worse.Conclusion: adult cervical spinal cord injury without fracture dislocation befo re MRI vertebral high signal,vertebral canal sagittal diameter are associated with nerve function after injury,and there are many segment stenosis of patients are more likely to suffer from severe cervical spinal injury.