The Study Of MRI Pre-and Post-operation On Cervical Spondylotic Myelopathy

Objective:To study the diagnosing value of MRI in cervical spondylotic myelopathy(CSM).Appling MRI to observe CSM morphology change of cervical vertebrae,measure compressed canalis spinalis and parties cerebrospinal fluid velocity for approach the value of MRI in CSM.Material and Methods:45 patients with spinal cord compresion were studied,measuring the sagittal diameter and the degree of spinal cord compression by MRI.Appling PC-MR to measure the cerebrospinal fluid velocity and postprocesse.Normal control 60 cases,first utilize routine scan by MRI to them to observe morphologic characteristics and canalis spinalis'sagittal diameter.Second utilize PC-MR measureing deck C1,C3,T1 cerebrospinal fluid' velocity.Applying the statistics software SPSS 13.0 to analysis them.Conclusion:The MRI finding in the 45 cases cervical spondylotic myelopathy,disci intervertebrales bulge 28 cases;intervertebral disk hernia 15 cases;interarticular cartilage calcify 9 cases;arcuate ligaments thickening 14 cases;artic hyperplasy 13 cases;spinal cord apomorphosis 17 cases;spinal stenosis 45 cases.After operation 11 cases of 17 cases spinal cord apomorphosis have recover.Spinal stenosis have improve.45 cases cervical spondylotic myelopathy preoperative sagital diameter of canalis spinalis in the average is 12.4±0.3mm,postoperative sagital diameter of canalis spinalis is 15.1±0.6mm.Spinal stenosis have improved,P＜0.05.After operation the clinical symptom of all cases have different degree improve,the recovery rate have dependability with the degree of cervical cord compression.The recovery rate ofⅠ,Ⅱ,Ⅲ,Ⅳdegree is 80.1%,71.6%,43.9%,21.3%.In 60 normal cases, measuring the velocity of C1,C3,T1 cerebrospinal fluid by PC-MR.In the C1 deck of normal volunteers the outflow and inflow peak velocity were 4.51±0.73cm/s and 2.52±1.06cm/s respectively.At the level of C3 the outflow and inflow peak velocities were 4.23±1.19cm/s and 2.55±0.72cm/s respectively. At the level of T1 the outflow and inflow peak velocities were 3.89±0.93cm/s and 2.10±0.51 cm/s respectively.In the C1 deck of 45 cases cervical spondylotic myelopathy the outflow and inflow peak velocities before operation were 3.04±0.47cm/s and 2.13±0.83 cm/s respectively.At the level of C3 the outflow and inflow peak velocities were 3.21±1.01cm/s and 2.24±0.68cm/s respectively. At the level of T1 the outflow and inflow peak velocities were 3.17±0.84cm/s and 1.69±0.33cm/s respectively.In the C1 deck of 45 cases cervical spondylotic myelopathy the outflow and inflow peak velocities after operation were 4.09±1.12cm/s and 2.29±1.09cm/s respectively.At the level of C3 the outflow and inflow peak velocities were 3.99±1.36cm/s and 2.31±0.84cm/s respectively. At the level of T1 the outflow and inflow peak velocities were 3.37±0.75cm/s and 1.81±0.48 cm/s respectively.After operation the velocity of CSF in all cases have different degree improve,the recovery rate have dependability with the degree of cervical cord compression.The recovery rate ofⅠ,Ⅱ,Ⅲ,Ⅳdegree is 93.6%,81.7%,50.3%,39.8%.The JOA Score have positive correlation with the velocity of the level of C1,r=0.653.Conclusion:1)Conventional MRI scanning can discover cervical spondylotic myelopathy morphology changes,can evaluate operative therapeutic effect.2)MRI can quantitate measure spinal stenosis and scale division the spinal stenosis.After operation the clinical symptom recovery of cervical spondylotic myelopathy have negative correlation with the degree of spinal stenosis.3)PC-MR is a noninvasive method to study the CSF flow in cervical spondylotic myelopathy and physiological for determining the pattern,direction, speed and quantity of the CSF flow.Therefore PC-MR is better than other invasive research modalities.