腰椎俯卧位MRI诊断腰痛和难治性神经根病患者的价值研究

Application of Lumbar Prone MRI in Patients with Low Back Pain and Difficultto-treat Radiculopathy

目的本研究旨在评估腰椎俯卧位MRI在腰痛和或难以治疗的神经根病患者中的应用。方法19名患有慢性中重度LBP和/或对常规治疗或介入治疗无效的根性疼痛的患者纳入本研究。仰卧位和俯卧位的磁共振成像都由专科医生进行分析,记录仰卧位和俯卧位MRI特征,包括椎管面积、侧隐窝直径、孔面积和黄韧带厚度。创建了不同病理模式的三维MRI重建。结果患者疼痛评分平均为6.5(R:4~8)。52.6%的病例只有俯卧位MRI才能看到椎间盘病变/增加的病变,有明显的屈曲和黄韧带增厚,而仰卧位MRI没有发现这一点。26.3%的病例仰卧位MRI未见的明显椎孔狭窄,而俯卧位病例中有。结论俯卧位MRI检查发现了四种病理改变,仰卧位没有观察到,俯卧位MRI可以作为常规仰卧位MRI一种重要补充。

Objective This study was designed to evaluate the application of lumbar prone MRI in patients with low back pain and difficult-to-treat radiculopathy,in order to provide reference for clinical diagnosis and treatment.MethodsNineteen patients with chronic moderate-to-severe LbP and/or root pain that did not respond to conventional or interventional therapy were included in the study.Magnetic resonance imaging in both supine and prone positions was analyzed by a specialist to record MRI features in both supine and prone positions,including spinal canal area,lateral recess diameter,foramen area,and thickness of ligamentum flavum.3D MRI reconstructions of different pathological patterns were created.Results The average pain score of patients was 6.5(R:4-8).In 52.6%of cases,disc lesions/increased lesions with significant flexion and thickening of the ligamentum flandum were seen only on prone MRI,which was not seen on supine MRI.In 26.3%of cases,there was no significant vertebral stenosis on MRI in supine position,but there was in prone position.Conclusion Four pathological changes were found in prone MRI,but not in supine MRI.Prone MRI can be an important supplement to conventional supine MRI.