Department of Radiology, Seoul National University Bundang Hospital, 300 Gumidong, Bundag-Gu, Seong Nam, Gyeongi-Do, 463-707, Korea.
Eur Radiol. 2013 Jan;23(1):205-11. doi: 10.1007/s00330-012-2566-3. Epub 2012 Jul 14.
To evaluate the MR-based outcome predictors of lumbar transforaminal epidural steroid injection (ESI) for lumbar radiculopathy caused by herniated intervertebral disc (HIVD).
A total of 149 patients (male/female 75:74; mean age 51.5 years) with the very worst (87 patients) or the very best outcome (62 patients) after ESI were enrolled in this study. They were selected from 1,881 patients who underwent lumbar transforaminal ESI for lumbar radiculopathy caused by HIVD from January 2007 to December 2008. Two radiologists reviewed MR in consensus. Chi-square test and Fisher's exact test were used to evaluate the difference between the two groups.
HIVD in the foraminal-extraforaminal zone were significantly more common in the very best outcome group (16/24, 66.6 %) than HIVD in the central-subarticular zone (46/125, 36.8 %) (P = 0.012). Other factors such as HIVD zone, T2-high signal, relation to nerve root, corner change, Modic change, disc height loss, grade of disc degeneration, and osteophyte were not statistically significant.
HIVD in the foraminal or extraforaminal zone is the only good MR-based outcome predictor of lumbar transforamial ESI for lumbar radiculopathy.
评估腰椎经椎间孔硬膜外类固醇注射（ESI）治疗椎间盘源性神经根病的 MRI 结果预测因子。
本研究共纳入 149 例（男/女 75:74；平均年龄 51.5 岁）接受 ESI 治疗后出现非常差（87 例）或非常好（62 例）结果的患者。他们是从 2007 年 1 月至 2008 年 12 月期间因椎间盘源性神经根病接受腰椎经椎间孔 ESI 治疗的 1881 例患者中选择的。两名放射科医生对 MRI 进行了共识审查。卡方检验和 Fisher 确切概率法用于评估两组之间的差异。
非常好结果组（16/24，66.6%）中椎间孔-椎间孔外区的椎间盘源性神经根病明显多于中央-关节突区（46/125，36.8%）（P=0.012）。其他因素，如椎间盘源性神经根病区域、T2 高信号、与神经根的关系、角变化、Modic 改变、椎间盘高度丢失、椎间盘退变程度和骨赘，没有统计学意义。
椎间孔或椎间孔外区的椎间盘源性神经根病是腰椎经椎间孔 ESI 治疗腰椎神经根病的唯一良好的 MRI 结果预测因子。
