单光子发射计算机断层扫描/计算机断层扫描对腰椎融合术后早期腰背部残余疼痛原因的诊断价值  

Diagnostic value of single-photon emission computed tomography/computed tomography for the causes of early residual lumbar and back pain after lumbar fusion

作　　者：孙新峰[1] 卢坤 郝晓飞 SUN Xinfeng;LU Kun;HAO Xiaofei(Department of Nuclear Medicine,Yellow River Sanmenxia Hospital,Sanmenxia 472000,Henan Province,China)

机构地区：[1]黄河三门峡医院核医学科,河南三门峡472000

出　　处：《新乡医学院学报》2024年第12期1155-1158,1164,共5页Journal of Xinxiang Medical University

摘　　要：目的探讨单光子发射计算机断层扫描(SPECT)/计算机断层扫描(CT)对腰椎融合术后早期腰背部残余疼痛原因的诊断价值。方法选择2019年1月至2021年6月黄河三门峡医院收治的106例腰椎融合术后腰背部残余疼痛而未得到解剖影像学明确诊断的患者作为研究对象。采用SPECT/CT显像检查患者疼痛原因,记录SPECT/CT显像检查结果,并以X线检查为金标准分析SPECT/CT对腰椎融合术后早期腰背部残余疼痛原因的诊断价值。结果SPECT/CT显像结果显示,106例患者中共85例(80.19%)显像阳性,其中椎间融合器无菌性炎症反应19例(17.93%),螺钉松动40例(37.73%),撞击综合征26例(24.53%);其余21例(19.81%)显像阴性。106例患者经X线检查证实阳性91例,其余15例为阴性。SPECT/CT显像诊断腰椎融合术后早期腰背部残余疼痛原因的敏感度、特异度、准确率、阳性预测值、阴性预测值分别为93.41%(85/91)、100.00%(15/15)、94.34%(100/106)、100.00%(85/85)、71.43%(15/21),kappa为0.800。结论具有解剖与功能影像的SPECT/CT显像对腰椎融合术后早期腰背部残余疼痛原因诊断价值较高。Objective To explore the diagnostic value of single-photon emission computed tomography(SPECT)/computed tomography(CT)for early residual lumbar and back pain after lumbar fusion.Methods A total of 106 patients treated in the Yellow River Sanmenxia Hospital from January 2019 to June 2021 for residual lumbar and back pain after lumbar fusion but without a definite diagnosis by anatomical imaging were selected as the research subjects.SPECT/CT imaging was used to examine the causes of pain,and the results of SPECT/CT imaging were recorded.Compared with the X-ray examination results as the gold standard,the diagnostic value of SPECT/CT for the causes of early residual lumbar and back pain after lumbar fusion was analyzed.Results SPECT/CT imaging showed that among the 106 patients,85 patients(80.19%)were positive,including 19 cases(17.93%)of aseptic inflammatory reaction to the interbody fusion cage,40 cases(37.73%)of screw loosening,and 26 cases(24.53%)of impingement syndrome.The rest 21 patients(19.81%)were negative.Among the 106 patients,91 patients were confirmed positive by X-ray examination,and the remaining 15 patients were negative.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of SPECT/CT imaging for the causes of early residual lumbar and back pain after lumbar fusion were 93.41%(85/91),100.00%(15/15),94.34%(100/106),100.00%(85/85),and 71.43%(15/21),respectively;and kappa was 0.800.Conclusion SPECT/CT imaging with anatomical and functional images has superior diagnostic efficacy for the causes of early residual lumbar and back pain after lumbar fusion.

关 键 词：腰椎融合术 腰背疼痛 单光子发射计算机断层扫描 计算机断层扫描 骨显像 

分 类 号：R687.3[医药卫生—骨科学]