磁共振成像参数对腰椎间盘突出症患者经皮椎间孔镜术疗效的预测价值分析  

Predictive value analysis of magnetic resonance imaging parameters for efficacy of percutaneous interforaminal endoscopy in patients with lumbar intervertebral discherniation

作　　者：孙建平 王秋珏 周兆金 周永荣 SUN Jian-ping;WANG Qiu-jue;ZHOU Zhao-jin;ZHOU Yong-rong(Radiology Department,Anhui Ma’anshan Traditional Chinese Medicine Hospital,Ma’anshan,Anhui 243000,China;Orthopedics and Traumatology Department,Anhui Ma’anshan Traditional Chinese Medicine Hospital,Ma’anshan,Anhui 243000,China)

机构地区：[1]安徽省马鞍山市中医院,放射科,安徽马鞍山243000 [2]安徽省马鞍山市中医院,骨伤科,安徽马鞍山243000

出　　处：《颈腰痛杂志》2023年第5期754-757,761,共5页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨磁共振成像参数对腰椎间盘突出症(lumbar disc herniation,LDH)患者经皮椎间孔镜术疗效的预测价值。方法前瞻性选取2020年1月~2020年11月马鞍山市中医院收治的107例LDH患者为研究对象,所有患者均行经皮椎间孔镜术,术前测定腰大肌、多裂肌参数,术后随访6个月。统计治疗效果,分析影响LDH患者经皮椎间孔镜术疗效的因素,分析腰部MRI参数对手术疗效的预测价值。结果失访2例。105例LDH患者中,75例(71.43%)疗效优,19例(18.10%)疗效良,11例(10.48%)疗效可。Logistic回归分析显示,△腰大肌横截面面积(“△”表示手术前后的变化值)、△腰多裂肌横截面面积是影响LDH患者经皮椎间孔镜术疗效的独立因素(OR:3.449、4.129,P<0.05)。ROC曲线结果显示,△腰大肌横截面面积、△腰多裂肌横截面面积及二者联合预测LDH患者经皮椎间孔镜术疗效的AUC分别为0.785、0.794、0.890。结论△腰大肌横截面面积、△腰多裂肌横截面面积与LDH患者经皮椎间孔镜手术疗效有关,二者联合预测LDH患者经皮椎间孔镜手术疗效有一定效能。Objective To explore the predictive value of magnetic resonance imaging parameters for the efficacy of percutaneous transforaminal endoscopy in patients with lumbar disc herniation(LDH).Methods A total of 107 patients with LDH admitted to Ma’anshan Hospital of Traditional Chinese Medicine were selected as the research object from January 2020 to November 2020.The patients were followed up for six months after the operation.The Results of the treatment were calculated and the factors affecting the efficacy of percutaneous intervertebral foraminal surgery were analyzed.The MRI lumbar spine was analyzed.The predictive value of parameters for the efficacy of percutaneous transforaminal endoscopy in patients with LDH was explored.Results Two cases were lost to follow-up.Among 105 patients with LDH,75 patients(71.43%)had excellent curative effect,19 patients(18.10%)had good curative effect,and 11 patients(10.48%)had good curative effect.Logistic regression analysis and multivariate analysis showed that the cross-sectional area of the psoas major muscle and the cross-sectional area of the lumbar multifidus muscle were independent factors affecting the efficacy of percutaneous transforaminal endoscopy in patients with LDH(OR:3.449,4.129,P<0.05).ROC curve Results showed that the AUC of the cross-sectional area of psoas major muscle,the cross-sectional area of lumbar multifidus muscle and the combination of the two to predict the efficacy of percutaneous interforaminal surgery in LDH patients was 0.785,0.794,0.890,respectively.Conclusion The cross-sectional area of the△psoas major muscle and the cross-sectional area of the lumbar multifidus muscle are related to the efficacy of percutaneous foraminal surgery in patients with LDH.The combination of the two predicts the efficacy of percutaneous foraminal surgery in patients with LDH.

关 键 词：腰椎间盘突出症 磁共振成像 经皮椎间孔镜术 疗效 

分 类 号：R681.5[医药卫生—骨科学]