腰椎间盘造影对人工椎间盘置换术的意义

The significance of lumbar discography in artificial disc replacement

目的:探讨椎间盘造影在人工腰椎间盘置换节段选择中的作用及意义。方法:对17例多节段或一般影像检查不能明确的腰椎退行性变患者的34个椎间隙行椎间盘造影检查,根据注入造影剂的量、注入时阻力、是否诱发出患者原有症状等确定责任椎间盘,并对相应节段行人工腰椎间盘置换术。结果:34个椎间隙造影中注入量大于2ml17个间隙,推注时阻力减低者17个间隙,诱发出患者原有症状19个间隙,无与造影相关的并发症。对19个诱发出患者原有症状的椎间盘进行了置换术。随访16￣42个月,平均30.4个月,术前患者JOA评分7￣17分,平均9.9分,术后JOA评分20￣29分,平均26.6分,差异有显著性(P<0.01)。结论:椎间盘造影对准确选择人工腰椎间盘置换节段能够提供重要的指导作用。

Objective：To study the significance of discography in segmental selection in artificial disc replacement（ADR）.Method：17 patients suffered from multi-level disc degeneration or incapable of cleared diagnosis by other image data.Based on the volume of Omnipaque injected,pressure of Omnipaque being injected, and patient＇s “typical” pain induced by the discography,the disc believed to be at least in part a source of the patient＇s pttin was selected as the replacement segment.Result：The volume of Omnipaque injected was greater than 2ml in 17 cases,pressure of Omnipaque being injected decreased in 17 cases,19 of 34 discs indicated “typical” pain.19 “pain-relative disc” of 17 patients accepted ADR.The average length of follow-up was 30.4 months（range,16 to 42 months ）.The average preoperative JOA was 9.9（range,7 to 17）,while postoperative JOA was 26.6 （range,20 to 29）.The pair-matching t test,t=-22.218,P〈0.01,indicated the significant difference.Conclusion：Discography take an important role in the segmental selection in ADR.