二维距离法和三维体积法对内镜下微创颈椎管成形后突出椎间盘再吸收的定量测量  

Quantitative measurement of resorption of cervical herniated disc after cervical microendoscopic laminoplasty by two-dimensional distance method and three-dimensional volume method

作　　者：吴彦禹 张春霖[1] 邵成龙 严旭[1] 刘小康[1] 王永魁 李东哲[1] Wu Yanyu;Zhang Chunlin;Shao Chenglong;Yan Xu;Liu Xiaokang;Wang Yongkui;Li Dongzhe(Department of Orthopedics,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州大学第一附属医院骨科,河南省郑州市450000

出　　处：《中国组织工程研究》2021年第21期3390-3394,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:文献报道内镜下微创颈椎管成形后出现不同程度的突出椎间盘再吸收现象,但目前尚未有统一的突出颈椎间盘测量方法。目的:运用二维距离法和三维体积法分别测量内镜下微创颈椎管成形后突出椎间盘体积,并对比观察其突出椎间盘再吸收现象,选出更准确可靠的测量方法。方法:回顾性分析郑州大学第一附属医院骨科2013年6月至2019年11月行内镜下微创颈椎管成形治疗的患者20例,其中男11例,女9例;年龄31-63岁,平均51岁;病程1-11个月,平均4个月。分别应用二维距离法和三维体积法测量突出颈椎间盘的突出程度,采用吸收比、吸收率、吸收度、再突出比及再突出率等指标评估测量结果。结果与结论:①患者随访时间为6-34个月,20例病例共67个突出椎间盘,二维距离组中有56个突出椎间盘术后发生突出椎间盘再吸收,三维体积组有61个突出椎间盘术后发生突出椎间盘再吸收,二者吸收比分别为84%和91%,差异无显著性意义(P> 0.05);二维距离组和三维体积组测算吸收度分别为12.30%-71.24%和7.71%-87.80%;②二维距离组及三维体积组少量吸收比、中量吸收比、大量吸收比分别为49%(33/67)、34%(23/67)、0(0/67)和36%(24/67)、49%(33/67)、6%(4/67),两组各吸收度之间差异有显著性意义(P <0.05);③二维距离组平均吸收率为31%,三维体积组平均吸收率为42%,二者差异有显著性意义(P <0.05);④二维距离组及三维体积组再突出比分别为1.49%(1/67)和0,二维距离组该椎间盘再突出率为12.18%;⑤内镜下微创颈椎管成形患者术后优良率为85%(17/20),无一例加重或死亡;⑥提示三维体积法是一种较二维距离法精度更高、更适合定量观察突出颈椎间盘体积的方法,可为脊髓型颈椎病诊疗提供可靠依据。BACKGROUND:Recent lite rature reported that patients with cervical herniated disc after cervical microendosco pic laminoplasty had extensive natural resorption of herniated nucleus pulposus,but there was still no unified measurement method for cervical herniated disc.OBJECTIVE:The methods by two-dimensional distance and three-dimensional volume were used to respectively measure and observe the resorption of herniated nucleus pulposus phenomenon after cervical microendoscopic laminoplasty,so as to evaluate and select a more accurate and reliable method.METHODS:Retrospective analysis was performed in 20 patients who underwent cervical microendoscopic laminoplasty in the Department of Orthopedics,First Affiliated Hospital of Zhengzhou University from June 2013 to November 2019,including 11 males and 9 females,aged 31 to 63 years old(averagely 51 years old),with a course of 1 to 11 months(averagely 4 months),Two-dimensional distance method and three-dimensional volume method were used to measure the degree of cervical herniated disc,and the absorption ratio,absorptivity,absorbancy,re-herniation ratio and re-herniation rate were used to evaluate the measurement results.RESULTS AND CONCLUSION:(1)The patients were followed up for 6 tp 34 months,with 67 cervical herniated discs in 20 cases.In the two-dimensional distance group,resorption of cervical herniated discs after surgery occurred in 56 patients.In the three-dimensional volume group,resorption of cervical hersniated disc after surgery occurred in 61 patients.The absorption ratios of the two were 84%and 91%,respectively,and the difference was not significant(P>0.05).The absorptivities of the two groups respectively were 12.30%-71.24%and 7.71%-87.80%in the two-dimensional distance group and three-dimensional volume group,respectively.(2)In the two-dimensional distance group and the three-dimensional volume group,the small absorption ratio,the medium absorption ratio and the la rge absorption ratio respectively were 49%(33/67),34%(23/67),0(0/67)and 36%(24/67),49%(33/

关 键 词：微创颈椎管成形 内镜 颈椎间盘 微创 二维距离 三维体积 椎间盘再突出 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]