Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, No 95, Yong'an Road, Xicheng District, Beijing 100050, China.
Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, No 95, Yong'an Road, Xicheng District, Beijing 100050, China.
J Clin Neurosci. 2020 Nov;81:455-461. doi: 10.1016/j.jocn.2020.10.011. Epub 2020 Nov 1.
To assess the preoperative and postoperative changes in MRI image and the short-term efficacy of the ISDF with BacFuse covering 3 years.
32 patients who underwent ISDF were involved in this retrospective study. The symptoms assessment including VAS, ODI, and SF-12 were evaluated preoperative and postoperative at 1 year and 3 years. The X-ray was used to measure posterior disk height (PDH), foramina height (FH), foramina width (FW), and MRI was taken to assess the cross-sectional area of dura sac (CSADS), cross-sectional area of canal (CSAC), herniated disc area, ligamentum flavum area. The preoperative ratio of herniated disc area and ligamentum flavum area to CSAC were compared with post-operative ratio. The modified Pfirrmann grade system was used to assess the surgical lumbar disc.
The symptom indexes were significantly improved after surgery. PDH and FH increased significantly (P < 0.05) after surgery compared with that before surgery, but there was no statistical difference in FW (P > 0.05). CSADS and CSAC increased obviously (P < 0.05), while the area of herniated disc and ligamentum flavum decreased significantly (P < 0.05). The ratio changes showed a significant difference between last follow-up and pre-operation (P < 0.05), but there was no statistical significance in grade changes of surgical disc.
ISDF with BacFuse could relieve clinical symptoms and expanse the spinal canal area in MRI. During 3-year observation, it could provide continuous traction and maintain the area of spinal canal, so as to partially retract the herniated disc and make it possible to repair the disc.
评估 ISDF 联合 BacFuse 术后 3 年的 MRI 影像学变化及短期疗效。
回顾性分析 32 例行 ISDF 手术的患者。采用视觉模拟评分(VAS)、Oswestry 功能障碍指数(ODI)和健康调查简表(SF-12)评估术前、术后 1 年和 3 年的症状。X 线片测量术后即刻、术后 1 年和术后 3 年的后缘椎间隙高度(PDH)、椎间孔高度(FH)、椎间孔宽度(FW),磁共振成像(MRI)评估硬脊膜囊横截面积(CSADS)、椎管横截面积(CSAC)、椎间盘突出面积、黄韧带面积。比较术前和术后椎间盘突出面积与黄韧带面积与 CSAC 的比值。采用改良的 Pfirrmann 分级系统评估手术节段腰椎间盘。
术后患者的症状评分均明显改善。术后 PDH 和 FH 明显增加(P<0.05),FW 无明显变化(P>0.05)。CSADS 和 CSAC 明显增加(P<0.05),椎间盘突出面积和黄韧带面积明显减少(P<0.05)。末次随访时与术前相比,比值变化有统计学意义(P<0.05),但手术节段椎间盘分级变化无统计学意义。
ISDF 联合 BacFuse 能缓解临床症状,扩大 MRI 椎管面积。在 3 年的观察期内,它能提供持续的牵引力,维持椎管面积,使椎间盘部分回缩,使椎间盘修复成为可能。