| Objective:To classify the high signal intensity ratio(HIR)in the upper spinal cord of patients with multilevel cervical spondylotic myelopathy(CSM)on magnetic resonance imaging(MRI T2W1)and to explore the correlation between the HIR grading system in the upper spinal cord of cervical spine on MRI T2W1 and the clinical effect after decompressionMethods:The clinical data of 50 patients with multilevel cervical spondylotic myelopathy accompanied by intramedullary high signal intensity changes on MRI T2WI were collected from January 2014 to December 2017.They were divided into<50%group(group A)and<50%group(group B)according to whether the improvement rate of nerve function was more than 50%.The high signal area of 0.1 cm2 and the normal intramedullary signal area of C7-T1 0.1 cm2 on the same sagittal plane were measured on cervical MRI T2WI,and the quantitative change rate of signal intensity was calculated According to JOA score,the quantitative change rate of intramedullary signal intensity before operation was graded 4.At the same time,the JOA score and neurological improvement rate at the last follow-up were compared among the groupsResults:All patients were followed up regularly for 6 to 24 months.There were no significant differences in sex ratio,age,course of disease,number of lesion segments,preoperative JOA score and follow-up time between the two groups(P>0.05).At the last follow-up,the JOA score of group A was 11.48±1.26,group B was 14.64±0.86,which was significantly lower than that of group B(P<0.05);the improvement rate of nerve function of group A was 0.27±0.11,and that of group B was 0.66±0.12,and the improvement rate of nerve function of group B was significantly better than that of group A(P<0.05).Conclusion:Preoperative grading of intram edullary high signal in MCSM is of guiding significance for evaluating prognosis.Surgery before the quantitative change rate of signal intensity reaches a higher level can improve the curative effect of surgery. |
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