Service d'imagerie médicale, hôpital l'Archet 2, CHU de Nice, route Saint-Antoine-Ginestière, Nice, France.
Diagn Interv Imaging. 2012 Jan;93(1):10-21. doi: 10.1016/j.diii.2011.10.001. Epub 2011 Dec 24.
Disc arthroplasty is the replacement of a painful pathological intervertebral disc by a prosthesis, which, unlike spinal fixation, has the advantage of retaining vertebral mobility in the segment concerned. The success of the procedure is dictated by the indication. The radiologist must look for radiographic arguments indicating or contraindicating fitting an implant, and particularly for the presence of facet arthritis which will prompt the surgeon to choose an arthrodesis. Moreover, radiological information plays a major part in preparing for a surgical procedure, as far as access to the disc via the anterior approach is concerned and assessment by CT angiography of the risk of vascular complications. After insertion, radiological monitoring using dynamic X-ray images checks that the implant is correctly positioned and that mobility is restored. In the long term, it can detect complications related to the prosthesis and premature wear to other points of support such as adjacent discs and the facet joints.
椎间盘关节成形术是用假体置换有病变的疼痛性椎间盘,与脊柱固定术不同,它具有保留相关节段椎体活动度的优势。手术的成功取决于适应证。放射科医生必须寻找影像学证据,以确定是否适合植入假体,特别是要寻找小关节关节炎的存在,因为小关节关节炎会促使外科医生选择融合术。此外,影像学信息在术前准备中起着重要作用,包括前路入路到达椎间盘的通道和 CT 血管造影评估血管并发症的风险。假体植入后,通过动态 X 射线图像进行影像学监测,以检查假体是否正确定位以及活动度是否恢复。从长远来看,它可以发现与假体相关的并发症以及其他支撑点(如相邻椎间盘和小关节)的早期磨损。