脊柱手术后并发症的MR表现及鉴别诊断

Analysis of MR findings and differential diagnosis in spinal postoperative complications

目的:探讨脊柱手术后并发症的MR表现和MR在诊断及鉴别诊断中的临床应用价值。方法:对114例行MRI检查的脊柱手术后并发症患者的影像学资料进行回顾性分析,并与临床资料进行对照。结果:脊柱手术后主要并发症:椎管狭窄33例(硬膜外血肿或脓肿所致12例,硬膜外纤维化与瘢痕形成21例);脊柱失稳43例;感染23例(术后椎旁软组织感染7例,椎间盘炎5例,椎体及附件感染4例,硬脊膜外脓肿3例,脊髓炎2例,脊蛛网膜炎2例);其他28例(内固定失败12例,硬膜外血肿9例,脑脊液漏7例)。结论:MRI可明确显示脊柱手术后的各种并发症,在其诊断和鉴别诊断中有独特价值。

Objective： To analyse MR findings in spinal postoperative complications and investigate the clinical applicative value of MRI in the diagnosis and differential diagnosis. Methods： MRI data of 114 cases of spinal postoperative complications were analyzed retrospectively and compared with the clinical data. Results： The main spinal postoperative complications includes： spinal stenosis （n=33, 21 cases of epidural fibrosis, 13 cases of epidural hematoma or epidural abscess）; lack of stability（n=43）; infection（n=23, 7 cases of para-spinal soft-tissue infection, 5 cases of vertebral discitis, 4 cases of vertebral and appendix infection, 3 cases of epidural abscess, 2 cases of myelitis, 2 cases of spinal arachnoiditis） and other （n=28, 12 cases of inner fixation failure, 9 cases of epidural hematoma, 7 cases of cerebrospinal fluid gusher）. Conclusion： MRI can specifically display all kinds of spinal postoperative complications, and has a significant value in diagnosis and differential diagnosis.