MSCT与MRI在椎间孔镜治疗腰椎间盘突出症患者疗效评估中的价值

Evaluated value of MSCT and MRI in the clinical efficacy of CT-guided percutaneous endoscopic transforaminal discectomy in the treatment of patients with lumbar disc herniation

目的:研究多层螺旋CT(MSCT)与磁共振成像(MRI)在CT导引下椎间孔镜(PETD)治疗腰椎间盘突出症(LDH)患者临床疗效中的评估价值。方法:将某院82例接受CT导引下PETD治疗的LDH患者随机均分为CT组和MRI组进行前瞻性研究,两组术后均采用视觉模拟评分(VAS)、日本骨科协会(JOA)评分和Oswestry功能障碍指数(ODI)随访疗效,同时分别于术后3个月时进行MSCT和MRI复查并分析各项指标与JOA评分的关系。结果:两组患者术后VAS和ODI评分明显降低,JOA评分明显升高(P<0.05);CT组患者术后3个月时椎管狭窄率、纵轴线长度和术区CT值明显降低(P<0.05),MRI组患者术后3个月时椎管狭窄率、椎间盘占位率和神经节ADC值均明显降低(P<0.05);LDH患者CT引导下PETD术后纵轴线长度和神经节ADC值与JOA评分呈明显负相关性(P<0.05)。结论:CT引导PETD治疗LDH具有良好效果,且MSCT和MRI可为评估手术效果提供参考信息。

Objective:To evaluate the value of multilayer CT(MSCT)and magnetic resonance imaging(MRI)in the clinical efficacy of foraminal oscopy(PETD)in patients with lumbar disc herniation(LDH).Methods:82 LDH patients receiving PETD under CT guidance from May 2020 to June 2023 were randomly divided into CT group and MRI group.In both groups,visual analog score(VAS),Japanese Orthopaedic Association(JOA)score and Oswestry functional dysfunction index(ODI),MSCT and MRI review were performed at 3 months after surgery,and analyzed the relationship between each index and JOA score.Results:postoperative VAS and ODI scores were significantly reduced in both groups,The JOA score was significantly increased(P<0.05),The inal stenosis rate,longitudinal axis length and CT value were significantly decreased(P<0.05),The spinal stenosis rate,disc space rate and ganglion ADC value were significantly decreased(P<0.05);The correlation axis length and ganglion ADC value and JOA score(P<0.05).Conclusion:CT-guided PETD for LDH has good results,and MSCT and MRI can provide reference information for the evaluation of surgical effect.