【摘要】 目的探讨单开门式椎板成形术后节段性运动功能障碍的发生原因及其与核磁共振(MRI)脊髓内T2加权高信号的关系。方法1993年1月～1998年10月,183例患者在日本应义塾大学整形外科接受了单开门式椎板成形手术,出现节段性运动功能障碍14例。采用回顾性方法,对术前、术后的临床症状、体征,术前、术后的MRI影像进行分析、评估。结果术后MRI显示所有14例患者脊髓内均有T2加权高信号改变,其中11例患者的MRI脊髓内T2加权高信号出现的节段与运动功能障碍节段一致。9例完全康复,其他5例仍有不同程度的力弱。结论单开门式椎板成形术后出现的节段性运动功能障碍,与术后MRI脊髓内出现的T2加权高信号影像有关。这种MRI脊髓内T2加权高信号影像可能是由于脊髓减压后,脊髓内血流急速再灌注而引起的;这种血流的急速再灌注,可能造成了脊髓灰质的某种损害而出现了节段性运动功能障碍。更多还原

【Abstract】 Objectives To explore the cause of motor paralysis after open-door laminoplasty(ELAP) and the relationship between the paralysis and T2 high signal of MRI. Methods 183 patients received operation of open-door expansive laminoplasty in Keio University from January 1993 to October 1998. Among them, 14 patients developed motor paralysis. The symptoms, signs and MRI images of pre- and post-operation had been studied retrospectively. Results post-operative MRI revealed T2 high signal intensity area in spinal cord in all 14 patients. The level of abnormal T2 high signal corresponded to the level of paralyzed segment in 11 of 14 patients. Paralysis resolved in 9 patients while mild motor weakness remained in 5 patients. Conclusion The segmental paralysis after open-door expansive laminoplasty is correlated to the T2 high signal of MRI in spinal cord. This kind of T2 high signal may be due to the rapid reperfusion after decompression of spinal cord which may cause some kind of impairment of spinal cord.更多还原