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The aim of the present study by performance cervical spine fracture and dislocation of the disc on MRI and surgery neck discography performance comparison study to explore the diagnostic and therapeutic value of intraoperative cervical disc angiography in the lower cervical spine fracture and dislocation, while the diagnostic value of MRI in the evaluation of preoperative. Parallel anterior or one patients with anterior method were treated from April 2007 to January 2011, 53 cases of cervical spine fracture dislocation, including 45 males and 8 females; aged 18 to 74 years, an average of 43.7 years . Injury factors: Traffic accident in 25 cases, falls injury in 23 cases, the bruise three cases, fall falls one cases, the other one cases. Injury to the patient underwent MRI examination time from 4 hours to 21 days, with an average of 3.4 days. Operative time average of 9 days after injury. All patients with cervical disc MRI according to Pearce classification [1] standard classification based on preoperative imaging data to determine the the operative segments and surgical methods, the anterior vertebral reset discectomy and decompression, bone fusion, titanium internal fixation or anterior vertebral subtotal iliac bone graft fusion plate fixation in some patients first reset posterior lateral mass screw fixation rod, and then the same period anterior decompression of vertebral interbody fusion surgery. Intended resection between disk and adjacent intervertebral disc surgery under direct vision imaging, and observe the posterior longitudinal ligament and intervertebral disc damage, angiography X-ray observation of the intervertebral disc and posterior longitudinal ligament injury and the camera records the image data, the contrast results according to the Adams discography classification standards [2] classification, this study, a total contrast to the intervertebral disc 150, 65 surgical resection. This study was double blinded, preoperative MRI films read by a radiologist chief physician judgment intervertebral disc and posterior longitudinal ligament injury, intraoperative angiography performed orthopedic physician, surgery profiler records posterior longitudinal ligament and disc injury . According to the intraoperative exploration results, the analysis of the angiographic results and preoperative MRI findings, evaluation of intraoperative cervical discography in the diagnosis and treatment of cervical fracture and dislocation, and verify that the MRI value. (1) 53 cases of cervical spine fracture dislocation were 150 damage and adjacent intervertebral disc research, based on the preoperative MRI findings, promiscuous 43 abnormal high signal or the level of the intervertebral disc injury signal angiographic results Adams grading standards IV level 8 Ⅴ grade 35; remaining 107 MRI findings of the intervertebral disc grading according to Pearce grading standards: I type: 6, Ⅱ: 34, Ⅲ type: 40, Ⅳ type: 22, Ⅴ type : 5. Angiographic results are classified according to the Adams X line, eight fractured, ruptured 35; intraoperative discography Adams X line, cotton balls type: 11, leaf type: 27, irregular: 42, fractured type: 17, ruptured: 10, the two sets of data using columns the contingency table chi-square test, Pearson X2 = 101.454, P = 0.000 lt; 0.05, it can be that the contrast grading and preoperative MRI cervical disc Pearce grading of a significant relationship, the association coefficient Gamma = 0.782, P = 0.000 lt; 0.05 between. (2) 53 patients with cervical fracture and dislocation preoperative the MRI diagnosis ago longitudinal ligament rupture 24 cases, 9 cases of posterior longitudinal ligament rupture disc injury of 63, after exploratory surgery and intraoperative angiography in the diagnosis of 33 cases of anterior longitudinal ligament rupture of the posterior longitudinal ligament rupture in 18 cases, 68 disc injury, MRI diagnosis of anterior longitudinal ligament rupture misdiagnosed three cases, 12 cases were missed, sensitivity of 63.63%, a specificity of 85.00%; diagnosis of posterior longitudinal ligament misdiagnosed 4 cases, 13 cases were missed, sensitivity 27.77 %, specificity 88.57%; the diagnostic disc injury missed five sensitivity of 92.64%; damage to the intervertebral disc surgery discography diagnosis 68 after the intraoperative exploration diagnosis consistent, sensitivity and positive predictive value were 100%. Conclusion (1) MRI in the preoperative diagnosis of cervical spine fracture dislocation of the intervertebral disc, ligament damage preferred check. (2) after MRI screening in patients with cervical fracture and dislocation, intraoperative angiography of the cervical disc can clear between the degree of disc injury, found adjacent segment disk the occult injury or degeneration. (3) intraoperative cervical discography MRI diagnosis reasonable complement to a reference value to determine the range of fusion and an evaluation of the adjacent intervertebral disc degeneration.
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