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评估胸部三柱骨折中的神经并发症:一种基于MRI的新型分类方法的临床应用

Yuan-Shun Lo^1,2, Ben-Long Shi³, Erh-Ti Ernest Lin¹

¹Department of Orthopedic Surgery, Division of Spine Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan.

|January 15, 2024

概括

在胸部三柱骨切除 (3CO) 中,基于MRI的脊髓形状的新型分类预测了神经系统并发症. 3型形态表明风险更高,有助于患者选择和脊柱形纠正手术规划.

科学领域:

神经外科神经外科
整形外科手术整形外科手术
放射学放射学是一门学科.

背景情况:

严重的脊柱形需要复杂的手术纠正,如三柱骨切除 (3CO).
在3CO的进步已经改善了结果,但神经系统并发症仍然是一个问题.
一个新的基于MRI的脊髓形态分类系统需要验证来预测这些并发症.

研究的目的:

在接受胸部3CO.CO.患者的神经并发症的调查.
使用基于MRI的分类来评估脊髓形状和曲线顶部的脑脊液.
评估这个分类对术后神经系统缺陷的预后能力.

主要方法:

对158名接受胸部3CO (2012年9月至2018年9月) 的成年患者进行了回顾性分析.
基于MRI的脊髓形态 (类型1,2,3) 在曲线顶部的分类.
对手术内神经生理监测警报和弗兰克尔分数 (手术前和术后) 的评估.

主要成果:

3型形态与更大的科布角 (P <0.001) 相关,并在术后持续存在.
在手术期间的神经生理监测警报发生在20.3%的患者中,在3型患者中明显高 (P <0.001).
在9.5%的患者中观察到新的术后神经缺陷,其中15例中有11例是3型形态.

结论:

胸部3CO中的3型脊髓形态与脊髓形严重程度的增加有关.
这种形态与手术前缺陷的可能性更高,以及手术后神经复发症的风险更高有关.
基于MRI的分类是预测胸部3CO.CO.患者手术后神经系统并发症的宝贵工具.

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