發(fā)布時(shí)間：2018-05-25 09:04

  本文選題：CT定位 + 腰椎間盤(pán)脫出�。� 參考：《中國(guó)矯形外科雜志》2017年15期

【摘要】：[目的]通過(guò)回顧總結(jié)脫出型腰椎間盤(pán)突出癥患者的影像和臨床資料,探討椎間盤(pán)脫出程度的矢狀位分度方法與髓核殘留的關(guān)系以及內(nèi)窺鏡治療策略。[方法]選擇2010年6月~2015年12月在本院行CT定位+脊柱內(nèi)窺鏡治療的脫出型腰椎間盤(pán)突出癥患者986例,其中L_(4/5)521例,L5/S1465例。將所有患者仰臥位64排螺旋CT掃描數(shù)據(jù)傳入GE AW4.3圖像后處理系統(tǒng),將椎體后緣四等分,以此描述椎間盤(pán)矢狀位脫出程度,分為Ⅰ、Ⅱ、Ⅲ、Ⅳ度;統(tǒng)計(jì)脫出程度與髓核殘留的關(guān)系。椎間盤(pán)脫出程度矢狀位分度統(tǒng)計(jì)結(jié)果:521例L_(4/5)脫出者Ⅰ度232例、Ⅱ度196例、Ⅲ度67例、Ⅳ度26例,465例L5/S1脫出者Ⅰ度187例、Ⅱ度215例、Ⅲ度50例,Ⅳ度13例;髓核殘留統(tǒng)計(jì)結(jié)果:986例脫出者中126例髓核殘留,Ⅰ度12例、Ⅱ度54例、Ⅲ度35例、Ⅳ度25例,椎間盤(pán)在矢狀面上脫出的程度越遠(yuǎn),髓核越容易殘留。[結(jié)果]所有患者隨訪(fǎng)10~76個(gè)月,平均37.60個(gè)月,JOA評(píng)分由術(shù)前的(8.40±3.20)分,增加到術(shù)后1周的(24.90±2.70)分,末次隨訪(fǎng)時(shí)為(27.30±3.90)分,與術(shù)前比較差異均有統(tǒng)計(jì)學(xué)意義(P0.01)。[結(jié)論]將椎間盤(pán)脫出程度進(jìn)行矢狀位分度,對(duì)于準(zhǔn)確評(píng)估手術(shù)的可行性、預(yù)測(cè)可能出現(xiàn)的問(wèn)題、指導(dǎo)手術(shù)入路的設(shè)計(jì)、保證手術(shù)的安全性、提高手術(shù)療效具有十分重要的意義。
[Abstract]:[objective] to review the imaging and clinical data of prolapse lumbar disc herniation, and to explore the relationship between sagittal degree of disc protrusion and nucleus pulposus residue and endoscope treatment strategy. [methods] 986 patients with prolapse lumbar intervertebral disc herniation were selected from June 2010 to December 2015, including 521 patients with L5 / S1465. 64-slice spiral CT scan data of supine position were transferred to GE AW4.3 image post-processing system. The posterior margin of vertebral body was divided into four equal parts to describe the degree of sagittal prolapse of intervertebral disc, which was divided into 鈪，

本文編號(hào)：1932865