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Prognostic value of magnetic resonance imaging combined with electromyography in the surgical management of cervical spondylotic myelopathy
The present study aimed to evaluate the value of pre-operative magnetic resonance imaging (MRI) combined with electromyography (EMG) for predicting clinical outcome following surgical management of cervical spondylotic myelopathy (CSM). A total of 94 patients with cervical compressive myelopathy wer...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
D.A. Spandidos
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3627454/ https://www.ncbi.nlm.nih.gov/pubmed/23596492 http://dx.doi.org/10.3892/etm.2013.934 |
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author | LIU, FA-JING SUN, YA-PENG SHEN, YONG DING, WEN-YUAN WANG, LIN-FENG |
author_facet | LIU, FA-JING SUN, YA-PENG SHEN, YONG DING, WEN-YUAN WANG, LIN-FENG |
author_sort | LIU, FA-JING |
collection | PubMed |
description | The present study aimed to evaluate the value of pre-operative magnetic resonance imaging (MRI) combined with electromyography (EMG) for predicting clinical outcome following surgical management of cervical spondylotic myelopathy (CSM). A total of 94 patients with cervical compressive myelopathy were prospectively enrolled and treated with anterior, posterior and posterior-anterior united decompression between October 2007 and February 2009. Prior to surgery 1.5-T MRI and EMG were performed in all patients. The patients were classified into four types based on the presence (+) or absence (−) of an increased signal intensity (ISI) on the T2-weighted magnetic resonance (MR) images and also based on the positive (+)/negative (−) results of the EMG. The four types were as follows: Type I, MRI/EMG (−/−); Type II, MRI/EMG (+/−); Type III, MRI/EMG (−/+); and Type IV, MRI/EMG (+/+). The clinical outcome was also graded according to a modified Japanese Orthopedic Association (JOA) scoring system. Furthermore, pre- and post-operative clinical data were statistically analyzed to explore the correlation between the factors. There were 36 cases (38%) of Type I, 16 (17%) of Type II, 13 (14%) of Type III and 29 (31%) of Type IV. According to the analysis of the clinical data between the four types, there were significant differences in the disability classifications, pre-operative JOA scores and disease duration (P<0.05), but there were no significant differences in gender, age or cord compression ratios (P>0.05). Until the final follow-up, there was a significant difference in the recovery ratio between the four study groups (Hc=27.46, P<0.05). Further comparison showed that the surgical outcome was best in Type I patients and worst in Type IV patients. In conclusion, there was a distinct correlation between classification and the rate of clinical improvement. Patients who had a negative EMG and those without an ISI on T2-weight images tended to suffer only mild symptoms, a short disease duration and, most significantly, experience a good surgical outcome. |
format | Online Article Text |
id | pubmed-3627454 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | D.A. Spandidos |
record_format | MEDLINE/PubMed |
spelling | pubmed-36274542013-04-17 Prognostic value of magnetic resonance imaging combined with electromyography in the surgical management of cervical spondylotic myelopathy LIU, FA-JING SUN, YA-PENG SHEN, YONG DING, WEN-YUAN WANG, LIN-FENG Exp Ther Med Articles The present study aimed to evaluate the value of pre-operative magnetic resonance imaging (MRI) combined with electromyography (EMG) for predicting clinical outcome following surgical management of cervical spondylotic myelopathy (CSM). A total of 94 patients with cervical compressive myelopathy were prospectively enrolled and treated with anterior, posterior and posterior-anterior united decompression between October 2007 and February 2009. Prior to surgery 1.5-T MRI and EMG were performed in all patients. The patients were classified into four types based on the presence (+) or absence (−) of an increased signal intensity (ISI) on the T2-weighted magnetic resonance (MR) images and also based on the positive (+)/negative (−) results of the EMG. The four types were as follows: Type I, MRI/EMG (−/−); Type II, MRI/EMG (+/−); Type III, MRI/EMG (−/+); and Type IV, MRI/EMG (+/+). The clinical outcome was also graded according to a modified Japanese Orthopedic Association (JOA) scoring system. Furthermore, pre- and post-operative clinical data were statistically analyzed to explore the correlation between the factors. There were 36 cases (38%) of Type I, 16 (17%) of Type II, 13 (14%) of Type III and 29 (31%) of Type IV. According to the analysis of the clinical data between the four types, there were significant differences in the disability classifications, pre-operative JOA scores and disease duration (P<0.05), but there were no significant differences in gender, age or cord compression ratios (P>0.05). Until the final follow-up, there was a significant difference in the recovery ratio between the four study groups (Hc=27.46, P<0.05). Further comparison showed that the surgical outcome was best in Type I patients and worst in Type IV patients. In conclusion, there was a distinct correlation between classification and the rate of clinical improvement. Patients who had a negative EMG and those without an ISI on T2-weight images tended to suffer only mild symptoms, a short disease duration and, most significantly, experience a good surgical outcome. D.A. Spandidos 2013-04 2013-01-30 /pmc/articles/PMC3627454/ /pubmed/23596492 http://dx.doi.org/10.3892/etm.2013.934 Text en Copyright © 2013, Spandidos Publications http://creativecommons.org/licenses/by/3.0 This is an open-access article licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. The article may be redistributed, reproduced, and reused for non-commercial purposes, provided the original source is properly cited. |
spellingShingle | Articles LIU, FA-JING SUN, YA-PENG SHEN, YONG DING, WEN-YUAN WANG, LIN-FENG Prognostic value of magnetic resonance imaging combined with electromyography in the surgical management of cervical spondylotic myelopathy |
title | Prognostic value of magnetic resonance imaging combined with electromyography in the surgical management of cervical spondylotic myelopathy |
title_full | Prognostic value of magnetic resonance imaging combined with electromyography in the surgical management of cervical spondylotic myelopathy |
title_fullStr | Prognostic value of magnetic resonance imaging combined with electromyography in the surgical management of cervical spondylotic myelopathy |
title_full_unstemmed | Prognostic value of magnetic resonance imaging combined with electromyography in the surgical management of cervical spondylotic myelopathy |
title_short | Prognostic value of magnetic resonance imaging combined with electromyography in the surgical management of cervical spondylotic myelopathy |
title_sort | prognostic value of magnetic resonance imaging combined with electromyography in the surgical management of cervical spondylotic myelopathy |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3627454/ https://www.ncbi.nlm.nih.gov/pubmed/23596492 http://dx.doi.org/10.3892/etm.2013.934 |
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