The Study Of MRI Pre- And Post-operation On Moderate To Severe Cervical Cord Compression

Objective:To study of MRI Pre- and Post-operation and General information on moderate to severe cervical cord compression. Summarizing the change of MRI Pre- and Post-operation. Guiding the treatment and Evaluating the effect. Methods:1.221 patients diagnosed with cervical spondylosis and 38 healthy controls were enrolled in the study from November 21, 2011 to May 15, 2013. Observing the cervical spine and spinal cord in compression. Measuring the sagittal diameter of canalis spinalis and spinal cord in compression. classifying into mild, moderate, severe three grades by Imaging evaluation standard and Imaging Features. Measuring the sagittal diameter of canalis spinalis and spinal cord in 38 healthy controls.2.Collecting the medical record including general information, Pre- and Post-operation imaging(hyperflexion,hyperextension, CT and MRI), Pre- and Post-operation JOA scors. Analyzing the changing in MRI and the relationship between MRI and spinal cord function Results:1. 221 patients with moderate to severe cervical cord compression were enrolled. There are 112 male and 59 female in the moderate group. The average age is 56.4 years(31 ~74 years) and the average course was 33.5 months(6-250 months). There are 36 male and 17 female in the severe group. The average age is 62.8 years(34 ~82 years) and the V average course was 43.1 months(6-241 months).2. Pre- and Post-operation JOA average scors were 7.96±2.54 and 12.42±2.18(P<0.05). The improvement rate were 65.45%±20.1% and 44.60±11.7%( P<0.005). The excellent cases was 13, good 125, mild 79 and poor 4. The excellent and good rate is 62.44%.3. Imaging analysis:The average sagittal diameter of canalis spinalis is 16.27±0.35 mm and the spinal cord in compression is 6.68±0.8mm in healthy controls. The average sagittal diameter of canalis spinalis is 12.3±0.32 mm and the spinal cord in compression is 5.81±0.41 mm in Pre-operation patients. The average sagittal diameter of canalis spinalis is 15.0±0.6mm and the spinal cord in compression is 6.77±0.65 in Post-operation patients.(P<0.05)4. Three patients who were given ACDF&ACCF operation suffered from paravertebral hematomas. The effect was good after given removing hematoma operation. There was no asphyxia or nerve injuries. One patient underwent C1-C7 laminectomy and fixation had bilateral C5 palsy after operation. The strengths of bilateral upper limb muscles was improved significantly after given symptomatic treatment and rehabilitation training at 6 months follow up. One patient suffered from cerebrospinal fluid leak. The symptom improved significantly and the wounds healed at the first grad. One patient who was given ACCF operation suffered from cough when drinking water slightly. The symptom improved significantly one week later and disappeared 3weeks follow up. Conclusion.1. Cervical spine MRI clearly show that whether the cervical intervertebral disc degeneration, prominent, cervical spinal cord degeneration necrosis or not. Analysis Cervical spinal cord injuries degree, nature, position objectively and omprehensively.2. According to the MRI of Post-operation patients, doctors can evaluate operation successful or not,effect and direct the rehabilitation exercises.3. Measuring the canalis spinalis and spinal cord in compression were significant in classifying grades. Directing operation or not and surgical options.4. Observing the MRI change with Pre- and Post-operation and judging remission or not in compression spinal cord. Providing direct basis for effcience evaluation by JOA scors. Directing the rehabilitation exercises.5. MRI of the cervical spine canal and spinal sagittal diameter measurement results and the patients with preoperative and postoperative JOA score improved a high degree of correlation.Postoperative recovery tests rely on MRI have limitations.