2.2. Sampling method
Random, convenient sampling, all patients selected according to the above criteria, no exclusion criteria in the period 09/2021 to 04/2022.
2.3. Information collection method
Collect research data from medical records at Hospital E.
Use a unified research medical record form.
MRI results with hernia level, type and extent and other information are answered from the Department of Diagnostic Imaging, E Hospital.
3. Variables to collect when researching
3.1. General characteristics of patients
Age, age group, average age.
Gender, male/female ratio.
Occupations related to illness:
Light labor: retired, office workers, students.
Heavy labor: workers, farmers, people who often have to carry heavy objects...
Other: some occupations are not clearly classified as heavy or light labor such as freelancers, drivers, etc.
Duration of illness: under 3 months, from 3 months to under 6 months, from 6 months to under 12 months, from 12 months to under 24 months, over 24 months.
Factors that trigger the disease include trauma, overwork, or incorrect posture.
Use a unified research medical record form.
MRI results with hernia level, type and extent and other information are answered from the hospital's imaging department.
3.2. Clinical and paraclinical characteristics
3.2.1. Clinical syndrome
Spinal syndrome
Pain and stiffness of the muscles next to the CSC
Has CSC pain points
Restrict CSC movement
Cervical root (nerve) syndrome
Cervical root pain
Pain increases when coughing, sneezing
Pain is reduced when stretching the spine
Numbness of upper limbs
Spurling's sign
Bell sign
Cervical root movement disorder
Cervical root reflex disorder
Upper limb muscle atrophy
Cervical spinal cord syndrome
TW type quadriplegia
HC Brown Sequard
Increased tendon reflexes in the limbs
Babinsky reflex
Hoffmann sign
Reduced sensation below the level of injury
TW-type sphincter disorder
3.3.2. CHT image
The patient underwent magnetic resonance imaging using the Siemens 1.5 tesla Essenza MRI system.
Method of analyzing results: using T1, T2 sagittal images and T1, T2 transverse images for diagnosis:
Sagittal T1 image for detection
Loss of physiological curve, hunchback
Reduced vertebral body height
Narrow intervertebral space
Anterior and posterior bone spurs
Image of cervical disc herniation posteriorly, anteriorly, into the vertebral body
Sagittal T2 image for detection
Reduced cervical disc signal
Image of herniated disc
Compression of the cerebrospinal fluid cavity
Increased spinal cord signal at the site of compression
Tear, hypertrophy of posterior longitudinal ligament, ligamentum flavum.
Cross-sectional T1 or T2 images for detection
Central hernia
Paracentral hernia
Graft foramen hernia
There is compression of the spinal cord, nerve roots, and the level of compression.
Measure some dimensions of the cervical spine
Anteroposterior diameter of the spinal canal on the T2 sagittal section across each vertebral body.
Anteroposterior diameter of the spinal canal on cross-sectional image.
Cervical cord diameter on sagittal T2 image.
Diameter of the spinal canal above and below the herniated area.
Spinal cord diameter across the herniation site.
We use the dimensions given in Chapter I as the standard for statistics and comparison.
The normal anterior-posterior diameter of the spinal canal is over 12 mm.
Mild spinal canal narrowing when the diameter is from 10mm to 12mm.
Severe stenosis when the diameter is less than 10 mm.
4. Data processing
Data analysis based on medical statistics software SPSS 18.0.
For qualitative variables: mean (X), standard deviation (SD), maximum, minimum values and confidence intervals.
For quantitative variables: calculate percentage.
Use χ2 to compare proportions, statistically significant when p < 0.05.
5. Research ethics
The study ensures that only measures are applied that do not affect the quality of hospital treatment, the health and economic interests of patients, and do not cause inconvenience to patients and medical staff.
The research topic has been approved by the expert council. We are committed to conducting the research with honesty and respect for patients. The information of the research subjects is guaranteed to be confidential.
CHAPTER 3. RESEARCH RESULTS
During the period from September 2021 to April 2022, at the Department of Neurosurgery, E Hospital, we selected 60 patients who met the selection criteria, with no exclusion criteria. The research results are as follows:
3.1. Clinical characteristics of CSC TVĐĐ
3.1.1. Distribution of patients by gender
42.42%
58.58%
Male Female
Figure 3.1. Distribution of patients by gender
Comments : Among the patients with the disease, there were 35 males and 25 females; Ratio: Male/Female 1.4/1.
13.3
43.4
50
45
40
35
30
25
20
15
10
5
0
20
20
3.3
≤ 30
31 – 40
41 – 50
51 – 60
Over 60
AGE GROUP
%
3.1.2. Patient distribution by age group
Figure 3.2. Distribution of patients by age group
Comment : The incidence of the disease is mainly in the age group of 51 - 60 (43.4%), the average age of patients is 54.03 ± 14.45, the lowest is 23 years old, the highest is 90.
3.1.3. Distribution of patients by occupation
Other
17%
Light
23%
Heavy
60
60%
Other Heavy Light
60%.
Figure 3.3. Distribution of patients by occupation
Comment : There are 36 people with occupations in the heavy labor group.
3.1.4. Distribution of patients according to triggering factors
25.7
22.7
After injury
Overwork, incorrect posture
Nature
51.6
Figure 3.4. Distribution of patients according to triggering factors
Comments : The triggering factors due to overwork and incorrect posture accounted for a high proportion (51.6%), the triggering factors after injury and naturally accounted for a lower proportion (22.7%) and (25.7%), respectively.
3.1.5. Distribution of patients according to disease duration
Table 3.1. Distribution of patients by time from onset to medical examination
Time
Number of patients (n=60) | Rate (%) | |
Under 6 months | 13 | 21.7 |
From 6 to under 12 months | 29 | 48.3 |
From 1 to 2 years | 10 | 16.7 |
Over 2 years | 8 | 13.3 |
Total | 60 | 100 |
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Comment : The number of patients with the disease for less than 1 year accounts for the majority of 70%.
3.1.6. Clinical syndromes
Table 3.2. Clinical syndromes of the disease
Syndrome
Number of patients (n=60) | Rate (%) | |
CSC syndrome | 40 | 66.7% |
Simple cervical root compression | 27 | 45% |
Simple cervical spinal cord compression | 8 | 13.33% |
Combined root and spinal cord compression | 25 | 41.67% |
Comments : Cervical spine syndrome (66.7%), simple cervical root compression syndrome (45%), combined root-spinal cord compression syndrome (41.67%), simple spinal cord compression syndrome (13.33%).
3.1.6.1. Symptoms of cervical spine syndrome
Table 3.3. Symptoms of cervical spine syndrome
Clinical symptoms
Number of patients (n=40) | Rate (%) | |
Pain and stiffness of the muscles next to the cervical spine | 25 | 62.5 |
There is cervical spine pain | 29 | 72.5 |
Limited cervical spine movement | 23 | 57.5 |
Comments : The majority of patients had pain and muscle stiffness near the cervical spine (62.5%), cervical spine pain points (72.5%), and limited cervical spine mobility (57.5%).