MRI检查发现椎间盘切除后的早期症状性椎间盘假性囊肿  

Early symptomatic intervertebral disc pseudocysts after discectomy detected on MRI

作　　者：游正秋 张中卒[1] 王群波[1] You Zhengqiu;Zhang Zhongzu;Wang Qunbo(Department of Orthopedics,Yongchuan Hospital Affiliated to Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院骨科,重庆市402160

出　　处：《中国组织工程研究》2023年第9期1403-1409,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:术后症状性椎间盘假性囊肿是椎间盘手术区域出现的囊性病变,一般在患者术后早期进行MRI检查时发现,目前关于其临床特点和发病机制的资料不足,其治疗方法仍存在争议。目的:探讨椎间盘切除后并发症状性椎间盘假性囊肿的临床特点、发病机制和治疗策略。方法:纳入2019年1月至2021年9月在重庆医科大学附属永川医院行椎间盘切除后并发症状性椎间盘假性囊肿患者7例,男5例,女2例,年龄35-60岁,回顾性分析其临床特点与治疗方法。结果与结论:(1)7例患者中,5例行经皮内镜腰椎间盘切除手术,2例行显微内镜椎间盘切除手术,术后患者腰腿痛症状均得到明显缓解。但术后症状均再次发作,术后MRI发现原手术区域T1加权像低信号,T2加权像呈高信号,并与椎间盘内相通,确诊为症状性椎间盘假性囊肿,MRI发现平均时间为椎间盘切除后32 d;(2)对于7例症状性椎间盘假性囊肿患者,4例给予止痛消肿、卧床休息等对症处理,1例行经皮内镜腰椎间盘切除手术,2例行显微内镜椎间盘切除手术,患者术后腰腿疼痛症状均得到明显缓解;术后1个月随访,MRI示原假性囊肿明显缩小;(3)结果提示,症状性椎间盘假性囊肿常见于椎间盘切除后早期,MRI可作为首选检查,当保守治疗无效时可行介入或者手术治疗,预后均较好。BACKGROUND:Postoperative symptomatic intervertebral disc pseudocyst is a cystic lesion in the area of inte rvertebral disc surgery.It is usually found in patients undergoing MRI examination in the early postoperative period.At present,there is insufficient data on its clinical chara cteristics and pathogenesis,and its treatment method is still controve rsial.OBJECTIVE:To investigate the clinical characteristics,pathogenesis and treatment strategy of symptomatic interve rtebral disc pseudocyst after discectomy.METHODS:Seven patients with symptomatic interve rtebral disc pseudocysts after intervertebral discectomy in the Yongchuan Hospital Affiliated to Chongqing Medical University from January 2019 to September 2021 were enrolled in this study.There were 5 males and 2 females,at the age of 35-60 years.Clinical features and treatments were retrospectively analyzed.RESULTS AND CONCLUSION:(1)Among seven patients,five patients underwent percutaneous endoscopic lumbar discectomy and two underwent poste rior microsco pic endoscopic discectomy.Their symptoms were significantly relieved after surgery.Howeve r,the symptoms recurred after the operation.The postope rative MRI showed low signal on T1 WI and high signal on T2 WI in the original ope ration area,and it communicated with the intervertebral disc,which was diagnosed as symptomatic intervertebral disc pseudocyst.The ave rage time for MRI to find the pseudocyst was about 32 days.(2)For seven patients with symptomatic intervertebral disc pseudocysts,four patients received analgesia and detumescence,bed rest and other symptomatic treatments;one patient received percutaneous endoscopic lumbar discectomy;two patients received microscopic endoscopic discecto my.Waist and leg pains were significantly relieved.At Z month after operation,MRI showed the original pseudocyst was significantly reduced.(3)The results indicate that symptomatic intervertebral disc pseudocyst usually occurs in the early postoperative period.MRI can be the first choice for examination.When conservati

关 键 词：腰椎术后 椎间盘囊肿 术后椎间盘假性囊肿 经皮椎间孔镜 椎间盘镜 腰椎间盘突出症 术后并发症 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R681.5