椎体后方结构及对突出椎间盘体积测量的影响  

Posterior vertebral structure and its influence on measurement of disc herniation volume

作　　者：牛策号 张春霖[1] 严旭[1] 付苏 冯阳 朱安迪 Niu Cehao;Zhang Chunlin;Yan Xu;Fu Su;Feng Yang;Zhu Andi(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》2023年第18期2897-2902,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:突出椎间盘体积测量是定量评估椎间盘突出程度的重要数据,以往在对内窥镜下微创颈椎管成形术后突出颈椎间盘体积的观察中发现,定量测量不能证实突出的颈椎间盘被完全吸收,可能与椎体后方一些不能吸收回纳的组织被包容在突出的椎间盘组织中一并被测量有关。目的:对比分析包含与去除椎体后方结构对突出腰椎间盘体积测量的影响,并初步观察内镜下微创腰椎管成形术后突出椎间盘体积的早期变化。方法:选择郑州大学第一附属医院收治的腰椎间盘突出患者98例(涉及191个椎间盘),收集患者内镜下微创腰椎管成形术前与术后1周的腰椎MRI影像资料,均应用PACS软件测量突出椎间盘体积,分2种测量方法:一组包含椎体后方结构,另一组去除椎体后方结构。比较两种测量方式下,手术前后突出腰椎间盘的缩小率、缩小比、不变比、增大比、增大率,以及术后1周的2种测量方法下的突出腰椎间盘的吸收比、吸收率。结果与结论:(1)包含组术后突出腰椎间盘体积缩小的有123个,缩小比64.4%,最大缩小率34.17%;体积不变的有45个,不变比23.6%;体积增大的有23个,增大比12%,最大增大率59.9%。去除组术后突出腰椎间盘体积缩小的有143个,缩小比74.9%,最大缩小率51.47%;体积不变的有28个,不变比14.7%;体积增大的有20个,增大比10.5%,最大增大率60.26%。(2)包含组术后突出腰椎间盘的吸收比、吸收率均低于去除组(P<0.01)。(3)结果显示,去除椎体后方结构进行突出腰椎间盘体积测量的方法更为接近实际状态,精准度更高;内镜下微创腰椎管成形术后早期即能广泛“诱导”突出的腰椎间盘发生自然吸收。BACKGROUND:Volume of disc herniation is an important measurement index for quantitative evaluation of disc herniation degree.Previously,the volume of cervical disc herniation that was completely absorbed after cervical microendoscopic laminoplasty was found unable to be confirmed by volume quantitative measurement.The reason was related to the fact that some tissues posterior to the vertebral body that could not be absorbed were included during measurement.OBJECTIVE:To compare and analyze the effect of inclusion and removal of the posterior vertebral structure on the volume measurement of herniated lumbar interve rtebral discs,and to preliminarily observe the early changes of the volume of herniated interve rtebral discs after lumbar microendoscopic laminoplasty.METHODS:Totally 98 patients with lumbar disc herniation(191 intervertebral discs)in First Affiliated Hospital of Zhengzhou University were enrolled.Lumbar spine MRI images of patients before and 1 week after lumbar microendoscopic laminoplasty were collected.The volumes were measured using PACS software.There were two measurement methods:one group included the posterior vertebral structure and the other group removed the posterior vertebral structure.The reduction rate,reduction ratio,unchanged ratio,enlargement ratio,and enlargement rate of the herniated lumbar intervertebral discs before and after the operation under the two measurement methods,and the absorption ratio and absorption rate of the herniated lumbar intervertebral disc under two measurement methods at 1 week after ope ration were compared.RESULTS AND CONCLUSION:(1)In the inclusion group,123 disc herniations with reduced volume after lumbar mic roendoscopic laminoplasty(reduction ratio of 64.4%,maximum reduction rate of 34.17%);45 disc herniations were unchanged in volume,ratio of 23.6%;23 disc herniations showed increase in volume,increase ratio of 12%,and maximum increase rate of 59.9%.In the exclusion group,143 disc herniations we re reduced in volume after lumbar microendoscopic laminopl

关 键 词：内镜下微创腰椎管成形术 突出腰椎间盘 自然吸收 突出腰椎间盘体积 椎体后方结构 MRI 

分 类 号：R445.2[医药卫生—影像医学与核医学] R319[医药卫生—诊断学] R681.5[医药卫生—临床医学]