Ploumis Avraam, Mehbod Amir, Garvey Timothy, Gilbert Thomas, Transfeldt Ensor, Wood Kirkham
Twin Cities Spine Center, Minneapolis, Minnesota 55404, USA.
Acta Orthop Belg. 2006 Jun;72(3):342-6.
The purpose of this prospective study was to compare the pseudarthrosis rate after anterior cervical fusion, estimated either with static and dynamic plain radiographs or with two-dimensional CT-scans. There is a plethora of radiographic tools and criteria used to determine pseudarthrosis after cervical spine fusion. However, it is not known to which extent these tools correlate with each other. Forty-seven adult patients were enrolled in this study, about one year after surgery. Four independent blinded observers evaluated the roentgenological data. CT assessment led to higher pseudarthrosis rates than plain radiographs: 13 to 31% according to CT; 2 to 16% according to plain radiographs. The difference averaged 11%. Consistency between reviewers was higher with CT (average agreement: 89%; range 82%-96%) than with plain radiographs (average agreement: 81%; range: 76% to 87%). The need to accurately document pseudarthrosis is critical as it helps direct the postoperative management of the patient. The present study stresses the value of computed tomography. However, surgical exploration continues to be the gold standard.
这项前瞻性研究的目的是比较颈椎前路融合术后假关节形成率，评估方法采用静态和动态X线平片或二维CT扫描。用于确定颈椎融合术后假关节形成的影像学工具和标准众多。然而，这些工具之间的关联程度尚不清楚。本研究纳入了47例成年患者，时间为术后约一年。四名独立的盲法观察者对影像学数据进行评估。CT评估得出的假关节形成率高于X线平片：根据CT为13%至31%；根据X线平片为2%至16%。差异平均为11%。与X线平片（平均一致性：81%；范围：76%至87%）相比，观察者之间对CT的一致性更高（平均一致性：89%；范围82% - 96%）。准确记录假关节形成情况至关重要，因为这有助于指导患者的术后管理。本研究强调了计算机断层扫描的价值。然而，手术探查仍是金标准。
