CT导引经皮腰椎间盘切除术的价值及疗效评价(附142例报告)

Estimation of the value and effects of CT guided PLD—Followed with reports of 142 cases

目的:探讨CT导引PLD的价值及对疗效评价。方法:本组142例计164个椎间盘,突出脱出者136个,膨出者28个。切割前先对靶椎间盘进行薄层扫描,并作穿刺参数的测量,所有病例均在CT监控下进行穿刺、切割。结果:穿刺成功率100%,无1例发生并发症。显效率651%,有效率2965,无效率53%。结论:1、CT导引有利于选择进针途径和穿刺入点,测量的穿刺参数真实、准确;可及时观察椎间盘被切割的范围和还纳复位情况,并免除了术者的X线的损伤。2、指出髓核突出伴软骨结节形成,外科术后复发仍可应用PLD治疗,对L5～S1行PLD时,CT更有利于选择进针途径;3。

Objectives:To study the value and estimate the curative effects of CT guided PLD.Methods:Among the 164 discs of 142 cases of patients,the discs of prolapse/herniation were 136,of bulge were 28.Thin layer scanning the target intervertebral discs before cutting and measured the parameters of puncture.All the patients were monitored with CT while puncturing and cutting.Results:The successful rate was 100%,no complication happened,the marked effective rate was 65.1%,effective rate 29.6%,ineffective rate 5.8%.Conclusions:1.Guided with CT can help to select the route of needling and the point of puncture;the parameters of puncture are true and accurate;it also can in time observe the cutting range of intervertebral discs and the state of shrinkage,can eliminate the injure of X-ray;2.The results indicated that it could treat with PLD when recurred after surgical operation for nucleus pulposus prolapse with chondrogenesis.CT can be more helpful to select the route of needling when treating with PLD to L 5～S 1;3.Also could indicate that it is not a positive proportional relation between the reposition of intervertebral disc and the immediate curative effect after operation.