Cervical spine clearance in obtunded patients after severe polytrauma / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To provide clinicians with data supporting three different clearance techniques in the obtunded patients after severe polytrauma.</p><p><b>METHODS</b>This study gave an overview of the available and pertinent literature regarding cervical spine clearance in obtunded patients after severe polytrauma.</p><p><b>RESULTS</b>Currently, there were three accepted techniques for clearance of the cervical spine in obtunded patients after severe polytrauma. Each of these methods has advantages and disadvantages to both of the patients and the clinicians.</p><p><b>CONCLUSIONS</b>There are continuous improvements in both computed tomography (CT) and magnetic resonance imaging (MRI) techniques that increase their sensitivities. The continued use of plain radiographs is called into question with respect to cost and time requirements. An algorithmic approach to the evaluation of the cervical spine in the obtunded patients will lead to fewer missed injuries.</p>

Position of increased signal intensity in the spinal cord on MR images: does it predict the outcome of cervical spondylotic myelopathy? / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Increased signal intensity (ISI) in the spinal cord on T2-weighted MR images has been reported in some previous researches, however no study focused on the position of the ISI in the spinal cord and its potential value. The aim of this study was to investigate the correlation between ISI position and the outcome of surgical treatment for cervical spondylotic myelopathy (CSM) patients.</p><p><b>METHODS</b>A retrospective study was conducted. Pre- and post-operative clinical status was evaluated by modified Japanese Orthopaedic Association (JOA) score. ISI was evaluated according to the T2-weighted sequences. The JOA score and the recovery ratios among patients with ISI in gray matter (group A), in both gray and white matter (group B), and ISI-negative group were compared.</p><p><b>RESULTS</b>Totally 64 patients were enrolled in this retrospective study. Preoperative JOA score of ISI positive and negative group had significant difference, but the recovery ratios had no significant difference (the recovery ratios of the two groups in week 1, week 26, and week 104 were (21.54 +/- 14.65)%, (50.56 +/- 14.76)%, (59.23 +/- 13.08)% and (20.25 +/- 14.32)%, (54.46 +/- 23.16)% and (61.26 +/- 29.4)%, respectively; P > 0.05). The recovery ratios of negative group and group A in week 104 were superior to group B (the recovery ratios of negative group, group A, and group B in week 104 were (61.26 +/- 29.49)%, (65.35 +/- 11.36)%, and (50.33 +/- 10.20)%, respectively; P < 0.05).</p><p><b>CONCLUSIONS</b>Patients with ISI in the gray matter alone on T2-weighted MR images did not have significantly different surgical outcomes compared with those without ISI. Patients with ISI in both gray and white matter had surgical outcomes that were worse than those without ISI.</p>