BACKGROUND Percutaneous endoscopic lumbar decompression(PELD)shows promise for lumbar spinal stenosis(LSS)treatment,but its use is limited by the disease's complexity and procedural challenges.AIM In this study,th...BACKGROUND Percutaneous endoscopic lumbar decompression(PELD)shows promise for lumbar spinal stenosis(LSS)treatment,but its use is limited by the disease's complexity and procedural challenges.AIM In this study,the effects of preoperative planning and intraoperative guidance with computed tomography(CT)/magnetic resonance imaging(MRI)registration techniques on PELD for LSS and postoperative rehabilitation outcomes were evaluated.METHODS This retrospective study was conducted with data from patients who underwent PELD for LSS between January 2021 and December 2023.Patients were assigned to preoperative CT/MRI registration and control groups.Data collected included the operative time,length of hospital stay,visual analog scale(VAS)scores for low back and leg pain,and the Japanese Orthopaedic Association(JOA)lumbar spine score.Differences between groups were assessed using Student’s t test.RESULTS Data from 135 patients(71 in the CT/MRI registration group,64 in the control group)were analyzed.The operative time was significantly shorter in the CT/MRI registration group(P=0.007).At 2 months postoperatively,both groups showed significant reductions in VAS leg and low back pain scores(all P<0.001)and improvements in the JOA score(both P<0.001).No complication or death occurred.Preoperatively,pain and JOA scores were similar between groups(P=0.830,P=0.470,and P=0.287,respectively).At 2 months postoperatively,patients in the CT/MRI registration group reported lower leg and low back pain levels(P<0.001 and P=0.001,respectively)and had higher JOA scores(P=0.004)than did patients in the control group.CONCLUSION Preoperative CT/MRI registration for PELD for LSS reduced the operative time and VAS pain scores at 2 months and improved JOA scores,demonstrating enhanced effectiveness and safety.展开更多
目的探讨1.5 T磁共振成像(magnetic resonance imaging,MRI)与64排多层螺旋计算机体层成像(computed tomography,CT)对脊柱骨折的诊断价值。方法方便选取2021年1月—2022年12月泰兴市第二人民医院收治的82例疑似脊柱骨折患者作为研究对...目的探讨1.5 T磁共振成像(magnetic resonance imaging,MRI)与64排多层螺旋计算机体层成像(computed tomography,CT)对脊柱骨折的诊断价值。方法方便选取2021年1月—2022年12月泰兴市第二人民医院收治的82例疑似脊柱骨折患者作为研究对象,均予1.5 T MRI与64排多层螺旋CT检查,以手术结果为金标准,评估两种技术对脊柱骨折的诊断效能,并分析其对脊柱骨折分型的诊断价值。结果1.5 T MRI对脊柱骨折诊断的准确度、灵敏度与64排螺旋CT比较,差异无统计学意义(P均>0.05)。两种方法与金标准一致性均较好(kappa值≥0.75)。1.5 T MRI对脊柱骨折A、B、C型分型诊断整体符合率为97.56%,高于64排多层螺旋CT的86.59%,差异有统计学意义(χ^(2)=7.111,P<0.05)。结论1.5 T MRI与64排螺旋CT对脊柱骨折诊断效能相当,但1.5 T MRI的分型诊断效能更高。展开更多
基金Supported by Health Commission of Shanxi Province,No.2021XM39.
文摘BACKGROUND Percutaneous endoscopic lumbar decompression(PELD)shows promise for lumbar spinal stenosis(LSS)treatment,but its use is limited by the disease's complexity and procedural challenges.AIM In this study,the effects of preoperative planning and intraoperative guidance with computed tomography(CT)/magnetic resonance imaging(MRI)registration techniques on PELD for LSS and postoperative rehabilitation outcomes were evaluated.METHODS This retrospective study was conducted with data from patients who underwent PELD for LSS between January 2021 and December 2023.Patients were assigned to preoperative CT/MRI registration and control groups.Data collected included the operative time,length of hospital stay,visual analog scale(VAS)scores for low back and leg pain,and the Japanese Orthopaedic Association(JOA)lumbar spine score.Differences between groups were assessed using Student’s t test.RESULTS Data from 135 patients(71 in the CT/MRI registration group,64 in the control group)were analyzed.The operative time was significantly shorter in the CT/MRI registration group(P=0.007).At 2 months postoperatively,both groups showed significant reductions in VAS leg and low back pain scores(all P<0.001)and improvements in the JOA score(both P<0.001).No complication or death occurred.Preoperatively,pain and JOA scores were similar between groups(P=0.830,P=0.470,and P=0.287,respectively).At 2 months postoperatively,patients in the CT/MRI registration group reported lower leg and low back pain levels(P<0.001 and P=0.001,respectively)and had higher JOA scores(P=0.004)than did patients in the control group.CONCLUSION Preoperative CT/MRI registration for PELD for LSS reduced the operative time and VAS pain scores at 2 months and improved JOA scores,demonstrating enhanced effectiveness and safety.
文摘目的探讨1.5 T磁共振成像(magnetic resonance imaging,MRI)与64排多层螺旋计算机体层成像(computed tomography,CT)对脊柱骨折的诊断价值。方法方便选取2021年1月—2022年12月泰兴市第二人民医院收治的82例疑似脊柱骨折患者作为研究对象,均予1.5 T MRI与64排多层螺旋CT检查,以手术结果为金标准,评估两种技术对脊柱骨折的诊断效能,并分析其对脊柱骨折分型的诊断价值。结果1.5 T MRI对脊柱骨折诊断的准确度、灵敏度与64排螺旋CT比较,差异无统计学意义(P均>0.05)。两种方法与金标准一致性均较好(kappa值≥0.75)。1.5 T MRI对脊柱骨折A、B、C型分型诊断整体符合率为97.56%,高于64排多层螺旋CT的86.59%,差异有统计学意义(χ^(2)=7.111,P<0.05)。结论1.5 T MRI与64排螺旋CT对脊柱骨折诊断效能相当,但1.5 T MRI的分型诊断效能更高。