CT与诱发电位相结合诊断腰椎间盘突出症的临床研究

A study of CT scan combined with dermatomal somatosensory evoked potential in the evaluation of lumbosacral disc herniation

目的研究CT与诱发电位在诊断腰椎间盘突出症中的作用。方法72例经手术证实的腰椎间盘突出症患者,手术前均进行腰椎间盘CT扫描和诱发电位检查(L5和S1),并对2种检查方法进行综合和比较。结果对照手术结果,CT扫描的诊断准确率为88.9%,诱发电位检查的诊断准确率为91.7%,2种检查方法联合应用的诊断准确率为100%。结论CT与诱发电位在诊断腰椎间盘突出症时各有优缺点,前者能直接显示椎间盘的形态改变,后者可判断神经根功能又可定位,两者应相互补充,为腰椎间盘突出症的诊断和治疗提供更全面的信息。

Objective To study the CT finding and dermatomal somatosensory evoked potential （DSEP） in pro-operative diagnosis of lumbosacral disc herniation （LDH）. Methods Pre-operative CT scan and DSEP （L5 and S1 ） were performed in 72 patients with LDH. All the cases were proved by surgical operation. Results In comparison with surgical findings, the accuracy rate of diagnosis using CT scan or DSEP was 88.9% and 91.7% respectively, while the accuracy rate approached 100% when an integrated consideration was made on both CT findings and the results of DSEP. Conclusion There are advantages and disadvantages on CT scan and DSEP in evaluation of LDH. CT imaging demonstrates the morphological alternations of the lesions, while DSEP reveals the level and severity of the damage of function of the nerve roots. Comprehensive and accurate information is indicated when both methods are integrated, which helps the diagnosis and management of LDH.