CT三维重建技术在腰椎退行性疾病MIS-TLIF中应用效果及影像学研究  

Effect and Imaging Study of CT 3D Reconstruction Tec hnique in Lumbar Degenerative Diseases MIS-TLIF

作　　者：刁浩峰[1] 李兰涛[1] 王晓灿 尹祖昌 王勇刚 DIAO Hao-feng;LI Lan-tao;WANG Xiao-can;YIN Zu-chang;WANG Yong-gang(Department of Orthopedics,The Fourth People's Hospital of Hengshui,Hengshui 053000,Hebei Province,China;Department of Imaging,The Fourth People's Hospital of Hengshui,Hengshui 053000,Hebei Province,China;Department of Bone Injury 2,Shaanxi Provincial Hospital of Chinese Medicine,Xi'an 710003,Shaanxi Province,China)

机构地区：[1]衡水市第四人民医院骨科,河北衡水053000 [2]衡水市第四人民医院影像科,河北衡水053000 [3]陕西省中医医院骨伤二科,陕西西安710003

出　　处：《中国CT和MRI杂志》2024年第12期171-174,共4页Chinese Journal of CT and MRI

基　　金：衡水市重点研发计划项目(2023014048Z)。

摘　　要：目的探讨CT三维重建技术在腰椎退行性疾病MIS-TLIF中应用效果及影像学结果。方法前瞻性选取2021年4月至2023年4月衡水市第四人民医院腰椎退行性疾病患者106例作为研究对象,随机数字表法分组,各53例。对照组采取MIS-TLIF,研究组采取CT三维重建技术辅助MIS-TLIF。统计2组围术期指标、影像学结果(置钉准确性、关节突关节侵犯程度、椎间融合状态)、并发症及手术前后细胞因子[白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、IL-17]、Oswestry功能障碍指数(ODI)、视觉模拟评分法(VAS)得分。结果与对照组比较,研究组术中出血量、透视次数较少,住院时间、每枚螺钉置入时间较短,手术时间较长(P<0.05);研究组Gertzbein-Robbins、FJV分级均优于对照组(P<0.05);术后1d,2组血清IL-10、TNF-α、IL-17含量均高于术前,且研究组低于对照组(P<0.05);术后5 d、6个月、12个月,2组VAS、ODI评分均低于术前(P<0.05);2组椎间融合状态及并发症发生率比较差异无统计学意义(P>0.05)。结论CT三维重建技术在腰椎退行性疾病MIS-TLIF中效果确切,有助于减少透视次数,提高置钉准确性,缩短住院时间,且对细胞因子影响较小。Objective To investigate the effect and imaging results of three-dimensional CT reconstruction in lumbar degenerative diseases MIS-TLIF.MethodsA total of 106 patients with lumbar degenerative diseases in The Fourth People's Hospital of Hengshui from April 2021 to April 2023 were prospectively selected as the study objects,and divided into 53 cases by random number table method.The control group was treated with MIS-TLIF,and the study group was treated with CT 3D reconstruction assisted with MIS-TLIF.Perioperative indicators,imaging results(nail placement accuracy,degree of penetration,interbody fusion status),complications,and cytokines[interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),IL-17]and Oswestry Dysfunction Index(ODI)and Visual Analogue Scale(VAS)scores before and after surgery were analyzed in 2 groups.ResultsCompared with the control group,the study group had less intraoperative blood loss and fluoroscopy times,shorter hospital stay and each screw insertion time,and longer operation time(P<0.05).The Gertzbein-Robbins and FJV grades of the study group were better than those of the control group(P<0.05).On the 1st day after operation,serum IL-10,TNF-αand IL-17 contents in 2 groups were higher than those before operation,and those in study group were lower than those in control group(P<0.05).At 5,6 and 12 months after surgery,VAS and ODI scores in 2 groups were lower than those before surgery(P<0.05).There was no significant difference in interbody fusion status and complication rate between the two groups(P>0.05).ConclusionCT 3D reconstruction is effective in lumbar degenerative diseases MIS-TLIF,which is helpful to reduce the number of fluoroscopy,improve the accuracy of nail placement,shorten the length of hospital stay,and has little effect on cytokines.

关 键 词：腰椎退行性疾病 CT三维重建技术 MIS-TLIF 影像学结果 

分 类 号：R681.57[医药卫生—骨科学]