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Preoperative Computed Tomography Myelography Parameters as Predictors of Outcome in Patients With Degenerative Cervical Myelopathy: Results of a Systematic Review

机译:术前计算机断层扫描脊髓造影参数作为退行性颈脊髓病患者预后的预测指标:系统评价的结果

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Study Design: Systematic review. Objectives: To determine the preoperative computed tomography (CT) myelogram imaging parameters in patients diagnosed with degenerative cervical myelopathy (DCM) that correlate with severity of DCM and predict postoperative patients’ functional outcome. Methods: An electronic database search was performed using Ovid Medline and Embase. CT myelogram studies investigating the correlation between imaging characteristics and DCM severity or postoperative outcomes were included. Two independent reviewers performed citation screening, selection, qualitative assessment, and data extraction using an objective and blinded protocol. Results: A total of 5 studies (402 patients) were included in this review and investigated the role of preoperative CT myelogram parameters in predicting the functional outcome after surgical treatment of DCM. All studies were retrospective cohort studies. CT myelogram characteristics included the transverse area of the spinal cord at maximum level of compression, spinal canal narrowing, number of blocks, spinal canal diameter, and flattening ratio. There is low evidence suggesting that patients with a preoperative transverse area of the spinal cord >30 mm2 at the level of maximum compression have better postoperative recovery and outcome. We found no studies investigating the correlation between preoperative CT myelogram parameters and DCM severity. Conclusions: Patients with greater transverse area of spinal cord at the level of maximum compression on the preoperative CT myelogram are more likely to have better neurological outcome after surgery. There is insufficient evidence to suggest that any of the other CT myelogram parameters investigated are predictors of postoperative outcomes in patients with DCM.
机译:研究设计:系统评价。目的:确定诊断为变性性颈椎病(DCM)的患者的术前计算机断层扫描(CT)脊髓影像学参数,这些参数与DCM的严重程度相关,并预测术后患者的功能结局。方法:使用Ovid Medline和Embase进行电子数据库搜索。 CT脊髓造影研究探讨了影像学特征与DCM严重程度或术后结果之间的相关性。两名独立的审稿人使用客观和盲目的方案进行了引文筛选,选择,定性评估和数据提取。结果:本研究共纳入5项研究(402例患者),研究了术前CT脊髓造影参数在预​​测DCM手术治疗后功能结局中的作用。所有研究均为回顾性队列研究。 CT脊髓造影的特征包括最大压缩水平时的脊髓横切面积,椎管变窄,块数,椎管直径和扁平率。很少有证据表明术前脊髓横断面> 30 mm 2 处于最大受压水平的患者术后恢复和预后较好。我们没有发现有关术前CT脊髓造影参数与DCM严重程度之间相关性的研究。结论:在术前CT脊髓造影上,脊髓最大横截面处于最大受压水平时,脊髓横断面积较大的患者在手术后更有可能获得更好的神经系统预后。没有足够的证据表明所研究的任何其他CT脊髓造影参数都是DCM患者术后结局的预测指标。

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