Chen Xin, Wang Jingming, Wang Lei, Xu Xiaoduo, Gong Qinglei, Huang Weimin
Orthopedic Department, 960 Hospital of People's Liberation Army, NO.25 Shifan Road, Jinan, 250031, Shandong, People's Republic of China.
Radiology Department, 960 Hospital of People's Liberation Army, NO.25 Shifan Road, Jinan, 250031, Shandong, People's Republic of China.
J Orthop Surg Res. 2025 May 16;20(1):472. doi: 10.1186/s13018-025-05895-w.
This systematic review aims to further explore the relationship between image and clinical features of spinal gas accumulation, propose a novel clinical classification based on CT images and clinical outcomes of surgical treatment and provide insights for new therapeutic strategies.
Studies with data on gas accumulation in the spinal were retrieved by searching PubMed, Embase, and Web of Science from inception to August 20, 2023, and screened following the PRISMA guidelines. Characteristic information, CT and MRI morphologic features, and surgical results of patients with gas accumulation in the spinal were reviewed, and patients were categorized according to preoperative CT findings.
A total of 41 articles were retrieved from the works of literature, including 53 patients with complete data. Among them, there were 29 males (59.70%) and 24 females (40.30%), with an average age of 65.8 years. We identified four types of gas accumulation in the spinal: Pseudocyst as pure gas (TypeI) with 34 cases (64.1%), Air cyst as epidural gas with a thin wall (TypeII) with 7 cases (13.2%), Air-contained disc herniation as epidural gas with disc herniation (Type III) with 3 cases (5.7%), intradural type (Type IV) with 9 cases(17.0%). 25 patients with Type I underwent non-conservative treatment and mild adhesions were observed in three patients. Adhesions were observed in 5 of the 6 Type II patients treated operatively. No adhesion was observed in three Type III patients. Adhesion was observed in 4 of 9 Type IV patients.
Gas accumulation in the spinal canal is a common clinical disease, which can be identified by CT and MRI. The classification based on CT scans helps guide clinical treatment.
本系统评价旨在进一步探讨脊柱气体积聚的影像学与临床特征之间的关系，基于CT图像和手术治疗的临床结果提出一种新的临床分类，并为新的治疗策略提供见解。
通过检索PubMed、Embase和Web of Science数据库，获取自数据库建立至2023年8月20日有关脊柱气体积聚的数据的研究，并按照PRISMA指南进行筛选。回顾脊柱气体积聚患者的特征信息、CT和MRI形态学特征以及手术结果，并根据术前CT表现对患者进行分类。
从文献中检索到41篇文章，包括53例具有完整数据的患者。其中男性29例（59.70%），女性24例（40.30%），平均年龄65.8岁。我们确定了脊柱气体积聚的四种类型：单纯气体假囊肿（I型）34例（64.1%），硬膜外含气薄壁囊肿（II型）7例（13.2%），硬膜外含气椎间盘突出伴椎间盘突出（III型）3例（5.7%），硬膜内型（IV型）9例（17.0%）。25例I型患者接受了非保守治疗，3例患者观察到轻度粘连。6例接受手术治疗的II型患者中有5例观察到粘连。3例III型患者未观察到粘连。9例IV型患者中有4例观察到粘连。
椎管内气体积聚是一种常见的临床疾病，可通过CT和MRI识别。基于CT扫描的分类有助于指导临床治疗。
