Foti Giovanni, Tripodi Gianluca, Ocello Giuseppe, Manenti Guglielmo, Merci Giorgio, Mignolli Thomas, Sanfilippo Lorenza, Guerriero Massimo, Serra Gerardo
Department of Radiology, IRCCS Sacro Cuore Hospital, 37024 Negrar, Italy.
Department of Radiology, Policlinico G. Martino, 98124 Messina, Italy.
Life (Basel). 2025 Apr 7;15(4):615. doi: 10.3390/life15040615.
to outline the role of CT in pre- and post-treatment evaluation in the case of lumbar endoscopic foraminotomy.
This prospective study, conducted between September 2020 and January 2024, included consecutive patients with clinical symptoms of lumbar sciatica/lumbalgia/lombo-cruralgia/lower limb peripheral neuropathy. Pre- and post-foraminotomy CT imaging was used to assess the foraminal diameters (cranio-caudal, transverse and free hand ROI area) before and after the treatment. Two independent blinded readers assessed the CT randomly. VAS pain scale and the measurements of each foramen were compared before and after treatment. Interobserver agreement was assessed using the Intraclass Correlation Coefficient (ICC).
A total of 47 participants were enrolled, with 53 intervertebral levels analyzed. The mean VAS value decreased from 9.17 in the preoperative period to 0.66 at the one-month postoperative follow-up. The clinical response was associated with statistically significant changes in the cranio-caudal and transverse diameters, as well as the area of the treated neuroforamina (-values < 0.05). Inter-rater reliability between the two operators ranged from 0.75 to 0.90.
CT can demonstrate a significant enlargement of the neuroforaminal diameters after the endoscopic foraminotomy, with good correlation with clinical improvement.
概述CT在腰椎内镜下椎间孔切开术治疗前后评估中的作用。
这项前瞻性研究于2020年9月至2024年1月进行，纳入了连续的有腰椎坐骨神经痛/腰痛/腰腿痛/下肢周围神经病变临床症状的患者。椎间孔切开术前和术后的CT成像用于评估治疗前后的椎间孔直径（颅尾径、横径和徒手感兴趣区面积）。两名独立的盲法阅片者对CT进行随机评估。比较治疗前后的视觉模拟评分（VAS）疼痛量表和每个椎间孔的测量值。使用组内相关系数（ICC）评估观察者间的一致性。
共纳入47名参与者，分析了53个椎间隙。术前VAS平均值为9.17，术后1个月随访时降至0.66。临床反应与颅尾径和横径以及治疗的神经椎间孔面积的统计学显著变化相关（P值<0.05）。两名操作者之间的评分者间信度范围为0.75至0.90。
CT可显示内镜下椎间孔切开术后神经椎间孔直径显著增大，与临床改善有良好相关性。
