[等压全螺纹动态内固定系统对腰椎髓核体积MRI测量下相邻节段退变的影响]

[Influence of isobar ttl dynamic internal fixation system on adjacent segment degeneration by mri measurement of lumbar nucleus pulposus volume].

作者信息

Huang Wenqiang, Shao Gaohai, Li Bo, Yu Yu, Qu Yiming, Wang Qunbo

机构信息

Department of Orthopedics, Yongchuan Hospital of Chongqing Medical University, Yongchuan Chongqing, 402160, P. R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 Jul 8;30(7):855-860. doi: 10.7507/1002-1892.20160174.

DOI:10.7507/1002-1892.20160174

PMID:29786322

Abstract

OBJECTIVE

?To investigate the influence of ISOBAR TTL dynamic internal fixation system on degeneration of adjacent intervertebral disc by MRI measurement of lumbar nucleus pulposus volume in treating lumbar degenerative disease after operation.

METHODS

?Between March 2010 and October 2011, 34 patients with lumbar intervertebral disc herniation (23 cases of paracentral type and 11 cases of lateral type) underwent operation with ISOBAR TTL dynamic internal fixation system for fixation of single segment, and the clinical data were analyzed retrospectively. There were 20 males and 14 females, aged 39-62 years (mean, 47.5 years). The disease duration was 6-18 months (mean, 14 months). Involved segments included L in 21 cases and L, S in 13 cases. The X-ray films and MRI images were taken at 6, 12, 18, 24, 36, and 48 months after surgery. Based on X-ray films, the height of intervertebral space was measured using angle bisectrix method. The nucleus pulposus volume was measured based on the MRI scan. The postoperative change of nucleus pulposus volume and intervertebral disc height were used to evaluate the influence of ISOBAR TTL system on degeneration of adjacent intervertebral disc nucleus pulposus.

RESULTS

?Thirty patients were followed up 48 months. The height of intervertebral space showed no significant difference between at pre-and post-operation (P>0.05). The nucleus pulposus volume increased after operation, showing no significant difference at 6, 12, and 18 months when compared with preoperative value (P>0.05), but significant difference was found at 24, 36, and 48 months when compared with preoperative value (P<0.05). The height of nucleus pulposus increased after operation but the width was decreased; the values showed no significant difference at 6, 12, and 18 months when compared with preoperative ones, but showed significant difference at 24, 36, and 48 months when compared with preoperative ones (P<0.05). The diameter of nucleus pulposus at 18, 24, 36, and 48 months after operation was significantly langer than that at preoperation (P<0.05).

CONCLUSIONS

?ISOBAR TTL dynamic internal fixation system can prevent or delay the degeneration of intervertebral discs.

摘要

目的

通过对腰椎退变疾病手术后腰椎髓核体积进行MRI测量，探讨ISOBAR TTL动力内固定系统对相邻椎间盘退变的影响。

方法

2010年3月至2011年10月，34例腰椎间盘突出症患者（中央型23例，外侧型11例）采用ISOBAR TTL动力内固定系统行单节段固定手术，对临床资料进行回顾性分析。男20例，女14例；年龄39～62岁，平均47.5岁；病程6～18个月，平均14个月。病变节段：L4～5 21例，L5～S1 13例。术后6、12、18、24、36、48个月摄X线片及MRI图像。根据X线片采用角平分线法测量椎间隙高度，基于MRI扫描测量髓核体积。以术后髓核体积及椎间盘高度的变化评价ISOBAR TTL系统对相邻椎间盘髓核退变的影响。

结果

30例患者获48个月随访。椎间隙高度术前、术后比较差异无统计学意义（P>0.05）。术后髓核体积增大，术后6、12、18个月与术前比较差异无统计学意义（P>0.05），术后24、36、48个月与术前比较差异有统计学意义（P<0.05）。术后髓核高度增加但宽度减小，术后6、12、18个月与术前比较差异无统计学意义，术后24、36、48个月与术前比较差异有统计学意义（P<0.05）。术后18、24、36、48个月髓核直径明显大于术前（P<0.05）。