| Research background:Thoracic spinal stenosis TSS is due to proliferation of the joint capsule thoracic Ossification of Ligmentum Flavum and Posterior vertebral Longitudinal Ligament, vertebral hyperplasia, slipped disc.Reasulting in spinal stenosis and spinal cord compression symptoms. MRI examination can clearly show the extent of damage to the spinal cord, thoracic spinal canal stenosis as an important imaging method. Found in daily clinical some patients the spinal cord appears as high signal (Increased signal intensity, ISI) on MRI T2W1. With high signal within the spinal cord lesion because the organization of long-term spinal cord compression, resulting in local ischemia. There is high signal suggest that spinal edema, degeneration and other pathological changes in the damage. For patients with preoperative cervical MRI examination of spinal cord high signal appears T2W1 and surgical prognosis, scholars around the world not yet have a unified point of view. Many scholars have done a study in the cervical spine, but still no consistent results. For the thoracic spinal stenosis patients, preoperative MRI imaging in the image of spinal cord on T2-weighted image high signal on the prognosis of surgery, So far the lack of relevant aspects of this.Objective:To investigate the thoracic spinal stenosis in patients with T2-weighted preoperative MRI examination phase appears high signal in patients with spinal cord surgery, and then discuss the preoperative intramedullary signal change on MRI TSS surgery prognosis.Methods:This retrospective analysis aims to our department in July 2008 February 2011 during the period of hospitalization and use of surgical treatment of TSS, a relatively complete follow-up data of 29 patients, including 21 males and 8females, average age:51.5±11.7 years (38 to 76 years). Duration of 6 months to 8 years. To take on a regular basis after review of all patients, telephone follow-up and questionnaire survey to collect data on patients. According to the severity of the preoperative and postoperative improvement, application of the Japanese Orthopaedic Association (JOA) score developed standards for lower extremity motor function scores before and after operation. All the patients according to preoperative MRI images of thoracic spinal cord is like a high T2 signal were grouped into T2 as T2 high signal as the signal group and the normal group, and the symptoms of these two groups of postoperative recovery, and these two groups The JOA score before surgery were compared. As in the spinal cord to determine with high T2 signal on the effect of extent of surgery. In the case of spinal cord high signal were divided into single segment will signal increased group and increased multi-segment signal group, the two groups by preoperative and postoperative improvement rate of JOA score were compared to observe the extent of spinal cord high signal The size of the degree of influence surgical treatment. Using SPSS 10.0 statistical package was used for statistical data analysis, before and after surgery using a paired t test comparison, (P value<0.05) was considered statistically significant. Results:(1) of all cases as high signal on T2 preoperative JOA score was 4.6±1.3 points, T2 signal the normal group as JOA score was 6.4±1.6 points, to compare the two, paired t test showed (Table 1) T2 Groups like the normal signal higher score than the signal group, compare the results statistically significant, according to (P <0.05), shows high T2 signal of spinal cord as the spinal cord between the degree of damage.(2) as high signal on T2 and the T2 group as the signal to improve the rate of the control group to compare the postoperative paired t test showed (Table 2) Comparison between the results of postoperative improvement rate was statistically significant, according to (P<0.05) shows high T2 signal within the spinal cord as the surgery has some degree of influence.(3) to compare the signal increased in a single segment and multi-segment signal groups increased the preoperative JOA score of the paired t test to compare the two results (Table 3) to compare the results statistically significant, according to (P<0.05) shows T2 hyperintense spinal cord appeared greater the scope, the extent of damage to the spinal cord more weight.(4) a single segment of the signal increased postoperative JOA score was 7.2±1.9, multi-segment signal group increased 6.1±1.5. The postoperative improvement rate of the two groups were compared, t test results showed that (Table 4) improvement rate after surgery compared between the two, according to statistically significant results (P<0.05), shows increased signal range of spinal surgery has some of the Degree of influence.Conclusion:In patients with thoracic spinal canal stenosis, MRI examination of spinal cord T2-weighted image high signal is where the performance of the injured spinal cord, and also increased the scope of the spinal cord signal related to the greater range of high signal appears that the injured spinal cord More severe. T2 appear as high signal within the spinal cord surgery there is a certain degree of influence, The greater the range of high signal appeared the worse surgery. |
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