Kotilainen E, Alanen A, Erkintalo M, Valtonen S, Kormano M
Departments of Neurosurgery and Surgery, University of Turku, Turku, Finland.
Minim Invasive Neurosurg. 2001 Mar;44(1):31-6. doi: 10.1055/s-2001-13584.
A total of 39 patients who had undergone microdiscectomy or percutaneous nucleotomy for lumbar disc herniation were examined after a follow-up of 5 years. The overall outcome was satisfactory in 80% of the patients treated, and only 1 (3%) patient had been reoperated during the follow-up. Clinical signs and symptoms of lumbar instability were detected in 10 (26%) patients. All these 39 patients had been examined with lumbar magnetic resonance imaging (MRI) on the day preceding the operation; the presence of disc degeneration was graded as severe, mild or non-existent depending on the visual brightness of the discs on T2-weighted images, as compared to the signal intensity of the lumbar vertebrae. None of the 12 patients with no preoperative disc degeneration in MRI suffered from postoperative clinical signs and symptoms of instability as compared to 10 (37%) of the 27 patients with mild or severe disc degeneration suffering from instability (p = 0.04). Thus, the results of the present study imply that the grade of the disc degeneration in preoperative T2-weighted MR images significantly predicted the occurrence of postoperative clinical instability.
对39例行腰椎间盘突出症显微椎间盘切除术或经皮髓核摘除术的患者进行了5年的随访检查。在接受治疗的患者中，80%的总体结果令人满意，随访期间只有1例（3%）患者接受了再次手术。10例（26%）患者检测到腰椎不稳的临床体征和症状。这39例患者均在手术前一天接受了腰椎磁共振成像（MRI）检查；根据T2加权图像上椎间盘的视觉亮度与腰椎信号强度相比，将椎间盘退变的程度分为重度、轻度或无退变。MRI术前无椎间盘退变的12例患者中，无1例出现术后不稳的临床体征和症状，而27例轻度或重度椎间盘退变患者中有10例（37%）出现不稳（p = 0.04）。因此，本研究结果表明，术前T2加权MR图像上的椎间盘退变程度可显著预测术后临床不稳的发生。
