Objective It is to observe the correlation of thoracic spinal stenosis with occurrence of intramedullary increased signal intensity (IISI) and clinical symptoms.Methods 99 patients who had thoracic spinal stenosis were clearly diagnosed and divided into 3 groups according to the degree of spinal stenosis: 34 cases in mild stenosis group (the residual rate of spinal canal ≥66.7%), 37 cases in moderate stenosis group (the residual rate of spinal canal ≥33.3% and <66.7%), 28 cases in severe stenosis group (the residual rate of spinal canal <33.3%).The occurrence rate of IISI and nerve function damage condition were recorded and analyzed respectively.Results 9 patients (26%) who with IISI were in mild stenosis group, 18 cases (49%) were in moderate stenosis group and 19 cases (68%) were in severe stenosis group, there was significant differ-ence among 3 groups (P <0.05).The Japanese Orthopedic Association (JOA) scale was 7.7 ±2.8 in group A, 6.3 ±2.0 in group B and 5.8 ±2.2 in group C, there was significant difference among them (P <0.05).The JOA scale was 4.9 ±1.5 in patients who had IISI and 7.2 ±2.1 in normal ones, there was significant difference between them (P <0.05).Conclusion In thoracic spinal stenosis patients, the more severe the spinal cord is compressed, the more likely the IISI occurred.Moreover, the occurrence of IISI tends to indicate a severely nerve damage.%目的：观察胸椎管狭窄症患者椎管狭窄程度与脊髓内高信号发生情况及临床症状之间的关系。方法根据胸椎管狭窄程度，将 MRI 检查确诊的99例胸椎管狭窄症患者分为3组：轻度狭窄组（椎管残余率≥66．7％）34例，中度狭窄组（33．3％≤椎管残余率﹤66．7％）37例，重度狭窄组（椎管残余率﹤33．3％）28例，比较各组患者脊髓内高信号的发生率及神经功能受损情况。结果在 MRI T2加权像上，轻度狭窄组有9例（26％）出现脊髓高信号改变，中度狭窄组有18例（49％），重度狭窄组有19例（68％），3组间比较差异具有统计学意义（P ＜0．05）；根据日本骨科协会（JOA）评分系统，轻度狭窄组 JOA 评分为（7．7±2．8）分，中度狭窄组为（6．3±2．0）分，重度狭窄组为（5．8±2．2）分，轻度狭窄组与中度狭窄组、轻度狭窄组与重度狭窄组间比较差异均有统计学意义（P 均＜0．05），而中度狭窄组与重度狭窄组比较差异无统计学意义（P ＞0．05）。脊髓内具有高信号的患者 JOA 评分为（4．9±1．5）分，无高信号者 JOA 评分为（7．2±2．1）分，二者比较差异有统计学意义（P ＜0．05）。结论因胸椎退行性疾病导致胸椎管狭窄的患者，胸椎管狭窄越重，病程越长，越容易出现髓内高信号；同时，髓内高信号的出现预示着神经受损程度更趋严重。
展开▼
