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弥散张量成像引导下经皮内窥镜腰椎间盘切除术的疗效分析。

Analysis of the Curative Effect of Diffusion Tensor Imaging-Guided Percutaneous Endoscopic Lumbar Discectomy.

机构信息

Affiliated Hospital of Weifang Medical University, School of Clinical Medicine, Weifang Medical University, Weifang, China.

出版信息

Curr Med Imaging. 2023;19(9):1084-1089. doi: 10.2174/1573405619666230206113414.

Abstract

BACKGROUND

Diffusion tensor imaging (DTI), a novel method of describing nerve structure, is a special form of magnetic resonance imaging (MRI). This new imaging method can be used to locate the diseased nerve roots in lumbar disc herniation.

OBJECTIVE

The objective of this study is to compare patient outcomes between single-level and doublesection percutaneous endoscopic lumbar discectomy (PELD) in the treatment of lumbar intervertebral disc herniation with single nerve root compression, where single-sided PELD is guided by magnetic resonance diffusion tensor imaging (DTI).

METHODS

The clinical data of patients with lumbar intervertebral disc herniation with double compression of single nerve root symptoms in the Affiliated Hospital of Weifang Medical University from January 2019 to May 2021 were retrospectively summarized and divided into single-level percutaneous endoscopic discectomy (PELD) group after DTI localization and double-section PELD group. The operation time, intraoperative bleeding, VAS score and JOA score of the two groups were compared, as well as the preoperative and postoperative fractional anisotropy (FA) values in the DTI group.

RESULTS

The operation time and intraoperative bleeding volume of patients in the DTI group were significantly lower than those in the double segment group, and there was no significant difference between VAS scores and JOA scores in the two groups. After the operation, the nerve root FA value of the responsible compression site of patients in the DTI group increased significantly, but it was still lower than the healthy symmetrical part.

CONCLUSION

The single-level PELD based on DTI has achieved a similar effect to that of the doublesegment PELD in 3 months after the operation, which can improve the FA value of the lesion nerve root. Its bleeding amount is less, and the operation time is shorter, but the efficacy of this technology still requires long-term follow-up of large samples.

摘要

背景

弥散张量成像(DTI)是一种描述神经结构的新方法,是磁共振成像(MRI)的特殊形式。这种新的成像方法可用于定位腰椎间盘突出症中患病神经根。

目的

本研究旨在比较磁共振弥散张量成像(DTI)引导单侧经皮内镜腰椎间盘切除术(PELD)与双节段 PELD 治疗单侧神经根受压的单节段腰椎间盘突出症患者的疗效。

方法

回顾性总结 2019 年 1 月至 2021 年 5 月潍坊医学院附属医院收治的单神经根双节段受压腰椎间盘突出症患者的临床资料,分为 DTI 定位下单节段 PELD 组和双节段 PELD 组。比较两组患者的手术时间、术中出血量、VAS 评分和 JOA 评分,以及 DTI 组患者术前、术后各责任受压神经根的部分各向异性(FA)值。

结果

DTI 组患者的手术时间和术中出血量明显低于双节段组,两组 VAS 评分和 JOA 评分差异无统计学意义。术后 DTI 组患者责任受压神经根的 FA 值明显升高,但仍低于健侧对称部位。

结论

基于 DTI 的单节段 PELD 在术后 3 个月与双节段 PELD 取得了相似的效果,可提高病变神经根的 FA 值,其出血量少,手术时间短,但该技术的疗效仍需要大样本长期随访。

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