Hounsfield units of vertebrae as a predictor of cervical deep paraspinal muscles atrophy and neck pain in degenerative cervical myelopathy.

IF 2.9 2区 医学 Q2 CLINICAL NEUROLOGY Journal of neurosurgery. Spine Pub Date : 2024-08-16 Print Date: 2024-12-01 DOI:10.3171/2024.5.SPINE231330
Jia Li, Jianning Liu, Ranxu Yang, Yong Shen, Linfeng Wang
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Abstract

Objective: This study investigated the correlation between Hounsfield units (HU) of the cervical vertebrae and atrophy of the cervical deep paraspinal muscles, namely the multifidus and semispinalis cervicis (SCer), in patients diagnosed with degenerative cervical myelopathy (DCM).

Methods: The authors retrospectively analyzed data from 136 patients aged 50-79 years (81 males and 55 females) who underwent surgical intervention for DCM. HU measurements of the cancellous bone in the C4 vertebra were acquired through standardized techniques. The authors evaluated fatty infiltration (FI); analyzed functional and vertebral cross-sectional area (CSA) of the multifidus and SCer at the C4-5, C5-6, and C6-7 levels; and analyzed the presence of Modic changes (MCs) and the incidence of axial neck pain.

Results: Patients were categorized into group A (n = 56) with mean ± SD HU of 293.3 ± 15.6 and group B (n = 80) with mean ± SD HU of 389.5 ± 10.6. Both groups demonstrated significant improvements in postoperative clinical outcomes (p < 0.05); however, no statistically significant difference was observed (p > 0.05). Significant disparities in HU measurements and visual analog scale (VAS) scores for neck pain were observed between the groups (p < 0.05). The highest VAS score correlated with MCs-1 type (i.e., low signal on T1-weighted images and high signal on T2-weighted images). The functional CSA to vertebral CSA ratios of the multifidus and SCer in group A were markedly reduced compared to those of group B (p < 0.05). No significant difference was noted in functional CSA asymmetry between the groups for both muscles (p > 0.05). Lower HU measurements directly correlated with increased FI in the multifidus (p = 0.002) and SCer (p = 0.035). Furthermore, a strong positive association was found between the functional CSA to vertebral CSA ratio of the multifidus and HU values (p = 0.003), whereas HU measurements and VAS scores exhibited a negative correlation (p = 0.020).

Conclusions: Among those patients older than 50 years with DCM, those with decreased HU values demonstrated elevated FI levels in the multifidus and SCer muscles. Moreover, these patients presented with pronounced muscle atrophy, which correlated with axial neck pain. A significant relationship was also identified between MCs and diminished HU values.

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预测退行性颈椎病患者颈椎深层脊柱旁肌肉萎缩和颈部疼痛的椎体 Hounsfield 单位。
研究目的本研究探讨了被诊断为退行性颈椎脊髓病(DCM)的患者颈椎的 Hounsfield 单位(HU)与颈椎深层脊柱旁肌肉(即多裂肌和颈半棘肌(SCer))萎缩之间的相关性:作者回顾性分析了 136 名年龄在 50-79 岁之间、接受过 DCM 手术治疗的患者(81 名男性和 55 名女性)的数据。通过标准化技术获得了 C4 椎体松质骨的 HU 测量值。作者对脂肪浸润(FI)进行了评估;分析了C4-5、C5-6和C6-7水平多裂肌和SCer的功能和椎体横截面积(CSA);分析了是否存在Modic改变(MCs)以及轴性颈痛的发生率:患者分为 A 组(n = 56)和 B 组(n = 80),A 组患者的 HU 平均值(± SD)为 293.3 ± 15.6,B 组患者的 HU 平均值(± SD)为 389.5 ± 10.6。两组患者的术后临床效果均有明显改善(P < 0.05),但无统计学差异(P > 0.05)。两组在颈部疼痛的 HU 测量值和视觉模拟量表 (VAS) 评分方面存在明显差异(P < 0.05)。最高的 VAS 评分与 MCs-1 类型(即 T1 加权图像上的低信号和 T2 加权图像上的高信号)相关。与 B 组相比,A 组多裂肌和 SCer 的功能 CSA 与椎体 CSA 比值明显降低(P < 0.05)。两组肌肉的功能CSA不对称性无明显差异(P > 0.05)。较低的 HU 测量值与多裂肌 (p = 0.002) 和 SCer (p = 0.035) 的 FI 值增加直接相关。此外,在多裂肌功能CSA与椎体CSA比值和HU值之间发现了很强的正相关性(p = 0.003),而HU测量值和VAS评分呈现负相关(p = 0.020):结论:在 50 岁以上的 DCM 患者中,HU 值降低的患者多裂肌和 SCer 肌肉的 FI 水平升高。此外,这些患者表现出明显的肌肉萎缩,这与轴性颈部疼痛有关。此外,还发现 MCs 与 HU 值下降之间存在重要关系。
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来源期刊
Journal of neurosurgery. Spine
Journal of neurosurgery. Spine 医学-临床神经学
CiteScore
5.10
自引率
10.70%
发文量
396
审稿时长
6 months
期刊介绍: Primarily publish original works in neurosurgery but also include studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology.
期刊最新文献
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