MRI T2WI High Signal Is a Risk Factor for Perioperative Complications in Patients with Cervical Spondylosis with Spinal Cord Compression: A Propensity Matching Score Analysis.

Shengsheng Huang,Liyi Chen,Chong Liu,Ming Yi,Tuo Liang,Jiarui Chen,Xinli Zhan,Jie Jiang,Xuhua Sun,Kai Uwe Lewandrowski

doi:10.1155/2022/8040437

Abstract

Objective The purpose of this study was to compare the perioperative complications and clinical efficacy of patients with cervical spondylosis with spinal cord compression (CSWSCC) with or without MRI T2WIHS (T2-weighted image high signal) by means of propensity matching score grouping. Methods We analyzed a single-center data of 913 surgical patients with CSWSCC by propensity matching score in this study, of which 326 patients had preoperative cervical MRI T2WIHS. The patient's general condition and perioperative indicators were collected. The MRI T2WIHS and normal groups were paired 1 : 1 to eliminate selection bias by propensity matching score. Finally, a total of 312 pairs were matched successfully. The results of perioperative complications and other outcome variables were compared between the two groups by Cox function analysis. Results The postoperative blood loss, operation time, blood transfusion volume, systemic complications, local complications, volume of drainage, abnormal use of antibiotic, length of hospital stay, and JOA (Japanese Orthopaedic Association) improvement rate were analyzed. As the only complication with significant statistical difference, the incidence of IRI (ischemia-reperfusion injury) in patients with MRI T2WIHS was significantly higher. The length of hospital stay was more significantly increased in patients with MRI T2WIHS; on the contrary, the JOA improvement rate decreased significantly. Conclusion This study confirmed that there was no significant difference in the incidence of perioperative complications in CSWSCC patients with or without MRI T2WIHS, except for the IRI. Moreover, the JOA improvement rate of patients without MRI T2WIHS was significantly better, with the length of hospital stay reduced.

Highlights

Long-term clinical studies have shown that the surgical treatment of cervical spondylosis with spinal cord compression (CSWSCC) is effective [1]
There has been no comparative study on perioperative complications in patients with CSWSCC with the Magnetic resonance imaging (MRI) T2WI high signal (T2WIHS) or normal group
We have presented that MRI T2WIHS was closely associated with the risk factors of systemic complications during perioperative period

Summary

Introduction

Long-term clinical studies have shown that the surgical treatment of CSWSCC is effective [1]. The surgical treatment of CSWSCC is mainly to relieve the compression of the spinal cord and nerves through surgical decompression so as to promote the recovery of nerve function. The main surgical treatment methods include anterior cervical discectomy with or without fusion, posterior decompression with or without fusion, and anterior and posterior combined decompression with internal fixation. The alteration of MRI T2WI high signal (T2WIHS) is closely related to spinal cord compression and clinical severity in patients with CSWSCC [4]. Many studies have shown that MRI T2WIHS imaging indicates a poor prognosis of surgical treatment, and the loss of high MRI T2 imaging signal after surgery indicates a long-term good prognosis of patients [5–7]. To date, there have been few comparative studies on perioperative

Methods

Discussion

Conclusion