| Purpose: The width of spinal cord,spinous process and dural sac,as well as the relative position relationship between spinous process and spinal cord,spinous process and dural sac,and spinal cord and dural sac were studied by cervical magnetic resonance imaging,so as to discuss the reliability of spinal cord stimulation electrode implantation in the treatment of postherpetic neuralgia under DSA with spinous process as the standard,so as to provide clinical reference.Method: Magnetic resonance images of cervical vertebra in our hospital from August 2020 to August 2021 were collected.The spinal cord,spinous process and dural sac widths at C2/3,C3/4,C4/5,C5/6,C6/7 and C7/T1 levels were measured,as well as the position relationship between the spinous process and the spinal cord,the spinous process and the dural sac,and the spinal cord and the dural sac,include the direction of the shift and grade the degree of shift as normal,mild,moderate,and severe,and statistically offset rate (total number of shifts)and moderate and severe offset rate(number of moderate and severe shifts/total),and statistically analyze all data.Results: A total of 96 images of cervical spine were studied,including 44 sequences in Y50-group and 52 sequences in Y50 + Group.Compared with group Y50-,the C4 spinous process in group Y50+ was narrower(P=0.02),and the spinal cord in group C4/5,C6/7 and C7/T1 was wider(P=0.02,P=0.04,P=0.01).There was no significant difference in the width of other spinous process,spinal cord and dural sac between the two groups(P>0.05).Compared with the spinal cord,14 cases(31.82%),18 cases(40.91%)and 12 cases(27.27%)of the spinous process in the Y50-group were offset on the right side of C2/3,and 29 cases(55.77%)in the Y50+ group were offset on the right side.There were 16 normal cases(30.77%)and 7 left deviation cases(13.46%),and the difference between the two groups was statistically significant(P=0.049).In the Y50-group,15 cases(34.09%),13 cases(29.55%),and 16 cases(36.36%)were migrated to the right of C3/4.In the Y50+ group,24 cases(46.15%)were migrated to the right,23 cases(44.23%)were migrated to the left,and 5 cases(9.62%)were migrated to the left.The difference between the two groups was statistically significant(P=0.007).In Y50-group,there were 19 cases(43.18%)of right-sided migration,23 cases(52.27%)of normal migration and 2 cases(4.55%)of left-sided migration.In Y50+ group,there were 33 cases(63.46%)of right-sided migration,11 cases(321.15%)of normal migration and 8 cases(15.38%)of left-sided migration.The difference between the two groups was statistically significant(P=0.007).In Y50-group,there were 17 cases(38.64%)of rightsided migration,15 cases(34.09%)of normal migration and 12 cases(27.27%)of left-sided migration.In Y50+ group,there were 18 cases(34.62%)of right-sided migration,19 cases(36.54%)of normal migration and 15 cases(28.85%)of left-sided migration.The difference between the two groups was statistically significant(P=0.004).For the other segments,there was no statistical significance between the two groups(P>0.05).Compared with the dural sac,there was no significant difference in spinous process migration between the two groups(P>0.05).Compared with the dural sac,there was no significant difference in spinal cord migration between the two groups(P>0.05).In terms of deviation degree,compared with spinal cord,23 cases(52.27%)of spinous process in Y50-group had normal deviation at C4/5,11 cases(25.00%)had mild deviation,10 cases(22.73%)had moderate deviation,and 0 cases had severe deviation.In Y50+ group,11 cases had normal deviation(21.52%),29 cases had mild deviation(55.77%),8 cases had moderate deviation(15.38%),and 4 cases had severe deviation(7.60%).The difference between the two groups was statistically significant(P=0.001).For the other segments,there was no statistical significance between the two groups(P>0.05).Equivalent to dural sac,there was no significant difference in the degree of spinal cord deviation between the two groups(P>0.05).Equivalent to the dural sac,there was no significant difference in the degree of spinous process deviation between the two groups(P>0.05).Compared with the spinal cord,the deviation rate of spinous processes from C2-C7 in Y50-group was 47.73-70.45%,and 55.77-69.23% in Y50+group.The spineous process in the Y50-group was 9.09-29.55% from C2-C7 to 29.55%,and the Y50+ group was 11.76-23.08%.Conclusion: This study shows that the spinous process of the cervical spine does not exactly correspond to the spinal cord,and there are significant differences in deviation between different ages.And there is a moderate to severe offset rate of 9.09-29.55%.The implantation of electrodes with spinous process as midpoint mark under DSA guidance often results in difficulty or failure of operation.Therefore,MRI of the cervical spine should be performed to provide the location of the spinous process to the spinal cord before the spinal cord electrode implantation. |
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