| Objective: To understand the imaging features,symptoms,functions and quality of life of patients with cervical spondylosis.Through the MRI evaluation of cervical spondylosis patients,the use of structural equation modeling method to investigate the relationship between MRI imaging changes in cervical spondylosis and cervical spondylosis symptoms,function and quality of life.To evaluate the predictive value of MRI in the symptoms,functions,and quality of life of cervical spondylosis,and to provide new ideas for the study of the use of MRI in cervical spondylosis.Methods: A total of 294 cases of cervical spondylosis diagnosed and treated by the Department of Rehabilitation Medicine of the outpatient department of West China Hospital of Sichuan University were investigated by questionnaires and scales,and routine cervical MRI was performed.According to MRI results,the Pfirrmann grade of cervical intervertebral disc degeneration was evaluated.On the basis of literature research,a structural equation model for the correlation between disc degeneration and symptoms,function and quality of life in patients with cervical spondylosis was established.Finally,AMOS 21.0 was used to analyze the data and the model.Results: 1.General information of patients participating in the study :A total of 294 valid data were available,including 102 males and 192 females.The average age was(48.09±12.66)years.Among them,18(6.12%)were teachers,60(20.41%)were staff,and 60(20.41%).Retired staff,27(9.18%)freelancers,33(11.22%)farmers,21(7.14%)workers,21(7.14%)catering(cookers,dishwashers),21 cases (7.14%)Other professional staff,including students,coaches,designers,etc.,33(11.22%)were unemployed.The VAS score of the study was(5.22±2.21),the SF-36 score was(549.15±129.54),the MRI score was(13.22±2.68),the NDI score was(0.19±0.12),and the SDRS score was(9.23±5.86).The HAMA score was(6.92±5.72)and the HAMD score was(8.53±6.76).2.Structural Equation Model Adaptation :The model path diagram was identified by AMOS software,it is concluded that the variance of the residual e2 of the initial model is negative,the RMSEA was 0.188(>0.08),the NFI was 0.587(<0.9),and the TLI was 0.872(<0.9),The standard level has not been reached.So further adjustments are made to the model.The corrected structural equation model CFI is 0.912(>0.9),GFI is 0.976(>0.9),and 4.78(<0.5)all meet the fitting standard.Although the RMSEA and TLI are not up to standard,for social science research,This kind of fitting has achieved good results,that is,the adaptability of the path model and real data can be achieved.3.The correlation:(1)There was a significant positive correlation between age and cervical MRI evaluation(Pfirrmann score)(P<0.01).The standardized regression coefficient was 0.568.(2)The correlation between sex and cervical MRI evaluation(Pfirrmann score)was no significant(P>0.05).(3)The MRI evaluation(Pfirrmann score)was positively correlated with the visual analogue scale(VAS)(P<0.01),the standardized regression coefficient was 0.177,and the MRI evaluation(Pfirrmann score)was significantly positively correlated with the NDI score(P<0.01).The regression coefficient was 0.272;the MRI evaluation(Pfirrmann score)was significantly negatively correlated with the SF-36 score(P<0.01),and the standardized regression coefficient was-0.085.(4)The VAS score and HAMD score were significantly negatively correlated with the SF-36 score(P < 0.01),and the standardized regression coefficient was-0.194 and-0.357 respectively.NDI score was significantly negatively correlated with SF-36 score(P < 0.01),and the standardized regression coefficient was-0.39.(5)The total effect of MRI assessment(Pfirrmann score)on the SF-36 score was-0.23.Among them,the direct effect is-0.085 and the mediating effect is-0.145.The ratio of the mediating effect to the total effect is 63.04%,the effect of Pfirrmann score on the SF-36 by VAS is-0.034,the effect on the SF-36 by NDI is-0.10,The mediating effect of MRI(Pfirrmann)?VAS?SF-36 was 23.68% of the total mediating effect,and the mediating effect of MRI(Pfirrmann)?NDI?SF-36 was 76.32% of the total mediating effect.Conclusion: 1.The structural equation model constructed by the study is well-adapted,and the results of the path coefficient of the model can truly reflect the correlation among imaging characteristics,symptoms,dysfunction and quality of life of patients with cervical spondylosis.2.There was a significant correlation among the imaging features of cervical spondylosis,pain,dysfunction,and quality of life.The imaging features mainly reflected the pathological changes of cervical spondylosis.Therefore,in clinical work,the pathology,symptoms,function,and quality of life of cervical spondylosis should also be taken seriously.3.The study of the correlation between MRI characteristics,symptoms,function and quality of life of cervical spondylosis has guiding significance for improving the quality of life of patients with cervical spondylosis.The quality of life of patients with cervical spondylosis is related to disc degeneration,pain,and dysfunction,and dysfunction is the most important factor affecting the quality of life of patients with cervical spondylosis.4.The MRI evaluation of cervical spondylosis has a certain predictive effect on the pain,functional status and quality of life of cervical spondylosis,and provides some reference for further study of imaging evaluation in the use of cervical spondylosis. |
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