OLIF联合后路固定术治疗腰椎滑脱椎管狭窄患者的CT、MRI观察  

CT and MRI Observation of OLIF Combined with PosteriorFixation for Lumbar Spondylolisthesis Stenosis

作　　者：杜英杰[1] 李晓军[1] 王玉满[1] DU Yingjie;LI Xiaojun;WANG Yuman(Chengde Medical University,Chengde 067000,Hebei,P.R.China)

机构地区：[1]承德医学院,河北承德067000

出　　处：《影像科学与光化学》2022年第2期325-330,共6页Imaging Science and Photochemistry

摘　　要：本文探讨基于计算机断层扫描(CT)、磁共振成像(MRI)的影像学技术观察评价其对斜外侧椎间融合术(OLIF)联合后路固定术治疗L4/L5腰椎滑脱椎管狭窄患者的应用价值。选取采取OLIF联合后路固定术治疗的L4/L5腰椎滑脱椎管狭窄患者118例进行回顾性研究,根据术后1年的随访效果将患者分为优良组(92例)和非优良组(26例)。结果显示,优良组的椎间隙高度、椎间孔面积、椎管面积增大值均显著大于非优良组患者(P<0.05);优良组的L4和L5腰大肌横截面积、L4和L5椎旁肌横截面积增大值均大于非优良组患者(P<0.05);优良组的ODI降低值、VAS降低分值均显著大于非优良组患者(P<0.05);椎间隙高度增大值、椎间孔面积增大值、椎管面积增大值、L4和L5椎旁肌横截面积增大值与患者手术前后ODI差值呈显著正相关关系(P<0.05)。采用CT、MRI对L4/L5腰椎滑脱椎管狭窄患者OLIF联合后路固定术治疗后进行随访,可观察患者术后椎间孔狭窄情况,以及临床症状解除后腰大肌及椎旁肌的恢复情况,对于判断患者腰椎功能恢复及手术效果具有一定的价值。This article discussed the application value of oblique lateral interbody fusion(OLIF)combined with posterior fixation in the treatment of patients with L4/L5 lumbar spondylolisthesis and spinal stenosis based on CT and magnetic resonance imaging techniques.A retrospective study of 118 patients with L4/L5 lumbar spondylolisthesis and spinal stenosis who underwent OLIF combined with posterior fixation was selected for a retrospective study,and the patients were divided according to the 1-year follow-up effect.There were 92 cases in the excellent group and 26 cases in the non-excellent group.The results showed that the height of the intervertebral space,the area of the intervertebral foramen,and the area of the spinal canal in the excellent group were all larger than those in the non-excellent group(P<0.05).The increase in the cross-sectional area of L4 and L5 psoas major and the cross-sectional area of L4 and L5 paraspinal muscles in the excellent group were greater than those in the non-excellent group(P<0.05).The ODI reduction and VAS reduction scores of the excellent group were greater than those of the non-excellent group(P<0.05).The increase of intervertebral space height,intervertebral foramen area,spinal canal area,L4 and L5 paravertebral muscle cross-sectional area were significantly positively correlated with the difference in ODI before and after surgery(P<0.05).CT and MRI are used to follow up patients with L4/L5 lumbar spondylolisthesis and spinal stenosis after OLIF combined with posterior fixation,it can observe the situation of postoperative foraminal stenosis and the recovery of psoas major and paraspinal muscles after clinical symptoms are relieved.The recovery situation is of certain value for judging the patient's lumbar function recovery and surgical effect.

关 键 词：计算机断层扫描 磁共振成像 斜外侧椎间融合术 后路固定术 腰椎滑脱 椎管狭窄 

分 类 号：R687.3[医药卫生—骨科学]