数字化全脊柱拼接结合核磁共振成像在青少年脊柱侧弯诊治的应用

Value of digital total spine splicing combined with magnetic resonance imaging in diagnosis and treatment of juvenile scoliosis

目的:探讨数字化全脊柱拼接结合核磁共振成像(MRI)在青少年脊柱侧弯诊断及治疗中的应用价值。方法:选取37例脊柱侧弯患者的数字化全脊柱拼接影像及其术前脊柱MRI影像,对其进行术前分析。通过数字化全脊柱拼接影像测量术前、术后cobb角变化,并结合MRI检查评估手术改善效果。结果:患者术前cobb角20°~40°有7例,40°~60°有13例,大于60°有17例。经手术矫正cobb角小于10°有26例,10°~20°有8例,20°以上有3例。其MRI影像显示伴半椎体畸形9例,伴蝴蝶椎1例,伴椎体楔形变3例,伴蛛网膜下腔增宽2例,伴脊髓中央管扩张2例,伴发栓系综合征1例,伴小脑扁桃体下疝1例,伴脊髓空洞1例,伴骶管闭合不全1例,其余未见异常。MRI影像对椎体及脊髓的异常检出率为100%。结论:通过数字化全脊柱拼接技术能明确患者侧弯段脊柱的治疗效果,为青少年脊柱侧弯修复及术后评估提供影像学依据;通过MRI可清晰地显示其椎体骨质及椎管内脊髓改变,为椎体病变的诊断及治疗起指导性作用;两者结合可作为青少年脊柱侧弯治疗重要的影像学检查方法。

Objective To assess the value of digital total spine splicing combined with magnetic resonance imaging（MRI） in the diagnosis and treatment of juvenile scoliosis.Methods The digital total spine splicing images and spinal MRI data of 37 adolescent patients with scoliosis were evaluated preoperatively.The digital total spine splicing images were used to analyze the postoperative changes of the Cobb angle,and the effectiveness of surgical correction was evaluated based on the spliced images and MRI results.Results Before surgical correction,a Cobb angle of 20°-40° was found in 7 cases,40°-60° in 13 cases,and more than 60° in 17 cases.After the operations,the Cobb angle was less than 10° in 26 cases,10°-20° in 8 cases,and more than 20° in 3 cases.MRI results showed concomitant conditions of hemiverte brain in 9 cases,butterfly vertebra in 1 case,vertebral wedging in 3 cases,subarachnoid cavity widening in 2 cases,central spinal cord dilatation in 2 cases,tethered cord syndrome in 1 case,cerebellar tonsillar hernia in 1 case,syringomyelia in 1 case,and sacral insufficiency in 1case;no abnormalities were found in the rest of the patients.MRI had a detection rate of 100% for abnormalities in the vertebrae and spinal cord.Conclusion Digital total spine splicing images clearly show the effect of surgical correction for scoliosis and provide imaging evidence for the treatment and postoperative assessment of juvenile scoliosis.MRI can also display the changes in the vertebral body and the spinal cord to assist in preoperative evaluation of scoliosis.The combination of digital total spine splicing images with MRI provides important imaging evidence for the treatment of juvenile scoliosis.