MRI和CT融合图像技术在椎间孔镜治疗腰椎间盘突出症中的应用价值

The application value of MRI and CT fusion image technology in the treatment of lumbar disc herniation with transforaminal endoscope

目的研究磁共振成像(magnetic resonance imaging,MRI)和电子计算机断层扫描(computed tomography,CT)融合图像技术在椎间孔镜治疗腰椎间盘突出症(lumbar disc herniation,LDH)中的应用价值。方法回顾性收集2016年2月~2021年2月我院LDH患者87例,并根据术前是否行MRI和CT融合图像检查分为两组,术前采用MRI和CT融合图像技术为观察组(n=44),术前未采用MRI和CT融合图像技术为对照组(n=43),均行椎间孔镜手术。比较两组手术指标、手术效果,术前、术后6个月采用疼痛数字评价量表(numerical rating scale,NRS评分)评估两组疼痛程度,采用日本骨科协会评估治疗分数(Japanese Orthopaedic Association Scores,JOA评分)评估腰椎功能,比较术后6个月并发症。结果两组手术指标、手术效果优良率比较,差异无统计学意义(P>0.05);术后6个月观察组NRS评分低于对照组(P<0.05);术后6个月观察组JOA评分高于对照组(P<0.05);观察组感觉异常发生率低于对照组(P<0.05)。结论MRI和CT融合图像技术可指导LDH患者椎间孔镜手术的操作,减轻疼痛程度,改善腰椎功能,并减少术后感觉异常的发生,提高手术安全性。

Objective To study the application value of magnetic resonance imaging(MRI)and computed tomography(CT)fusion image technology in the treatment of lumbar disc herniation(LDH)with transforaminal endoscope.Methods Eighty-seven patients with LDH in our hospital from February 2016 to February 2021 were retrospectively collected and divided into two groups according to whether MRI and CT fusion image technology was performed before operation.The observation group(n=44)was performed MRI and CT fusion image technology before operation,and the control group(n=43)was not performed MRI and CT fusion image technology before operation.All patients underwent transforaminal endoscope surgery.The operation indexes and therapeutie efficacy of the two groups were compared,and the pain degree of the two groups was evaluated with the numerical rating scale(NRS score)before and 6 months after operation,and the lumbar function was evaluated with the Japanese Orthopaedic Association Scores(JOA score),and the complications 6 months after operation were compared.Results There was no significant difference in the operation indexes and therapeutie efficacy between the two groups(P>0.05).The NRS score of the observation group was lower than that of the control group 6 months after operation(P<0.05).The JOA score in the observation group was higher than that of the control group 6 months after operation(P<0.05).The incidence of paresthesia in the observation group was lower than that in the control group(P<0.05).Conclusion MRI and CT fusion image technology can guide the operation of transforaminal endoscope surgery in patients with LDH,reduce the degree of pain,improve lumbar function,reduce the occurrence of postoperative sensory abnormalities and improve the safety of surgery.