CT导引臭氧腰椎间盘靶向注射的影像学特征

The imaging characters of CT-guided ozone target-injecting technic for lumbar intervertebral disk hernian

目的探讨经皮穿刺臭氧腰椎间盘靶向注射治疗腰椎间盘各型突出的穿刺路径,观察臭氧在椎间盘和突出物的分布。方法123例经皮穿刺腰椎间盘臭氧消融术患者,根据突出节段分别在CT下进行薄层扫描,根据突出类型选择合适穿刺路径,注射臭氧后CT扫描观察气体分布状况。结果75例L4～5椎间盘穿刺全部成功采用后外侧路径。85例L5～S1椎间盘穿刺全部采用小关节内缘侧隐窝路径。臭氧在椎间盘髓核腔内积聚状分布43例,裂隙状分布64例,弥漫分布状62例。46例L4～5和L5～S1椎间盘突出物大于1/3矢状径的突出,29例在突出物内和突出物表面分布,17例在突出物表面分布。结论CT导引臭氧腰椎间盘消融术穿刺定位精确,可以进行椎间盘和突出物靶向注射,同时可观察注射后气体在目标部位的分布状况。

Objective To observe the imaging characters of CT-guided ozone target-injecting technic for lumbar intervertebral disk hernia. Methods Thin layer （3 mm） CT scanning on intervertebral disk of L4-s （38 cases） and 14-SL （48 cases） was performed in 123 cases with lumbaral intervertebral disk hernia. Puncture approach was choosen according to different types of prominence. Os was injected and destribution of ozone was observed by means of CT scanning. Results Puncture of L4 -5 intervertebral disk via posterolateral route was successsly used in 75 cases. Punture of L5-S1 interveretebral disk via lateral recess route was successsly used in 85 cases. The The accumulative destribution of ozone in disk was seen in 43 cases, crack-like destribution in 64 cases, and diffuse distribution in 62 cases. The disk prominence of 46 cases was greater than 1/3 saggital drive,of which distribution of ozone was inner in 29 cases and on the surface of the prominence in 17 cases. Conclusion The CT-guided ozone target-injection of lumaral intervetebral disk and prominence has the advantages of accurate location, target-injection and easy observation of ozone distribution in diseased area.