Patient Distribution According to Time From Onset to Diagnosis

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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Patient Distribution According to Time From Onset to Diagnosis

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%).

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