PDF(Pubmed)
Abstract：
BACKGROUND: How to quickly read and interpret intraoperative ultrasound (IOUS) images of patients with degenerative cervical myelopathy (DCM) to obtain meaningful information? Few studies have systematically explored this topic.
OBJECTIVE: To systematically and comprehensively explore the IOUS characteristics of patients with DCM.
METHODS: This single-center study retrospectively included patients with DCM who underwent French-door laminoplasty (FDL) with IOUS guidance from October 2019 to March 2022. One-way ANOVA and Pearson\'s /Spearman\'s correlation analysis were used to analyze the correlations between the cross-sectional area of the spinal cord (SC) and individual characteristics; the relationships between the morphology, echogenicity, pulsation, decompression statuses, compression types of SC, location of the spinal cord central echo complex (SCCEC) and the disease severity (the preoperative Japanese Orthopedic Association score, preJOA score); the difference of the spinal cord pulsation amplitude(SCPA) and the SCCEC forward movement rate (FMR) between the compressed areas(CAs) and the non-compressed areas (NCAs).
RESULTS: A total of 38 patients were successfully enrolled (30 males and 8 females), and the mean age was 57.05 ± 10.29 (27-75) years. The cross-sectional area of the SC was negatively correlated with age (r = - 0.441, p = 0.006). The preJOA score was significantly lower in the heterogeneous group than in the homogeneous group (P < 0.05, p = 0.005). The hyperechoic area (HEA) was negatively while the SCCEC FMR was positively correlated with the preJOA score (r = - 0.334, p = 0.020; r = 0.286, p = 0.041). The SCCEC FMR and SCPA in CAs were significantly greater than those in NCAs (p < 0.05, p = 0.007; P < 0.001, P = 0.000).
CONCLUSIONS: The cross-sectional area of the SC decreases with age in adults. More changes in intramedullary echogenicity and less moving forward of the SCCEC often indicate poor SC status, and the SCCEC FMR and SCPA are more pronounced in CAs.
OBJECTIVE: To systematically and comprehensively explore the IOUS characteristics of patients with DCM.
METHODS: This single-center study retrospectively included patients with DCM who underwent French-door laminoplasty (FDL) with IOUS guidance from October 2019 to March 2022. One-way ANOVA and Pearson\'s /Spearman\'s correlation analysis were used to analyze the correlations between the cross-sectional area of the spinal cord (SC) and individual characteristics; the relationships between the morphology, echogenicity, pulsation, decompression statuses, compression types of SC, location of the spinal cord central echo complex (SCCEC) and the disease severity (the preoperative Japanese Orthopedic Association score, preJOA score); the difference of the spinal cord pulsation amplitude(SCPA) and the SCCEC forward movement rate (FMR) between the compressed areas(CAs) and the non-compressed areas (NCAs).
RESULTS: A total of 38 patients were successfully enrolled (30 males and 8 females), and the mean age was 57.05 ± 10.29 (27-75) years. The cross-sectional area of the SC was negatively correlated with age (r = - 0.441, p = 0.006). The preJOA score was significantly lower in the heterogeneous group than in the homogeneous group (P < 0.05, p = 0.005). The hyperechoic area (HEA) was negatively while the SCCEC FMR was positively correlated with the preJOA score (r = - 0.334, p = 0.020; r = 0.286, p = 0.041). The SCCEC FMR and SCPA in CAs were significantly greater than those in NCAs (p < 0.05, p = 0.007; P < 0.001, P = 0.000).
CONCLUSIONS: The cross-sectional area of the SC decreases with age in adults. More changes in intramedullary echogenicity and less moving forward of the SCCEC often indicate poor SC status, and the SCCEC FMR and SCPA are more pronounced in CAs.
摘要：
背景：如何快速读取和解释退行性颈椎病（DCM）患者的术中超声（IOUS）图像以获取有意义的信息？很少有研究系统地探讨了这一主题。
目的：系统全面地探讨DCM患者的IOUS特征。
方法：这项单中心研究回顾性纳入了2019年10月至2022年3月在IOUS指导下接受法式门椎板成形术（FDL）的DCM患者。采用单因素方差分析和Pearson/Spearman相关分析,分析脊髓横截面积(SC)与个体特征的关系;回声,脉动,减压状态,SC的压缩类型，脊髓中央回声复合体（SCCEC）的位置和疾病的严重程度（术前日本骨科协会评分，前JOA评分）；压缩区域（CA）和非压缩区域（NCA）之间的脊髓搏动幅度（SCPA）和SCCEC向前运动速率（FMR）的差异。
结果：共38例患者成功入选（男30例，女8例），平均年龄57.05±10.29(27～75)岁。SC的横截面积与年龄呈负相关（r=-0.441，p=0.006）。异质组的前JOA评分显著低于同质组(P<0.05,p=0.005)。高回声面积（HEA）呈负相关，而SCCECFMR与前JOA评分呈正相关（r=-0.334，p=0.020；r=0.286，p=0.041）。CAs中的SCCECFMR和SCPA明显大于NCAs（p<0.05，p=0.007；P<0.001，P=0.000）。
结论：成人SC的横截面积随着年龄的增长而减小。髓内回声的变化越多，SCCEC的前移越少，通常表明SC状态较差，SCCECFMR和SCPA在CA中更为明显。
目的：系统全面地探讨DCM患者的IOUS特征。
方法：这项单中心研究回顾性纳入了2019年10月至2022年3月在IOUS指导下接受法式门椎板成形术（FDL）的DCM患者。采用单因素方差分析和Pearson/Spearman相关分析,分析脊髓横截面积(SC)与个体特征的关系;回声,脉动,减压状态,SC的压缩类型，脊髓中央回声复合体（SCCEC）的位置和疾病的严重程度（术前日本骨科协会评分，前JOA评分）；压缩区域（CA）和非压缩区域（NCA）之间的脊髓搏动幅度（SCPA）和SCCEC向前运动速率（FMR）的差异。
结果：共38例患者成功入选（男30例，女8例），平均年龄57.05±10.29(27～75)岁。SC的横截面积与年龄呈负相关（r=-0.441，p=0.006）。异质组的前JOA评分显著低于同质组(P<0.05,p=0.005)。高回声面积（HEA）呈负相关，而SCCECFMR与前JOA评分呈正相关（r=-0.334，p=0.020；r=0.286，p=0.041）。CAs中的SCCECFMR和SCPA明显大于NCAs（p<0.05，p=0.007；P<0.001，P=0.000）。
结论：成人SC的横截面积随着年龄的增长而减小。髓内回声的变化越多，SCCEC的前移越少，通常表明SC状态较差，SCCECFMR和SCPA在CA中更为明显。
