| 姜建元,王洪立,马昕,吕飞舟,夏新雷,王立勋.椎间盘造影在腰椎多节段退变性疾病诊治中的应用探讨[J].脊柱外科杂志,2011,9(4):195-199. |
椎间盘造影在腰椎多节段退变性疾病诊治中的应用探讨  点此下载全文 (Fulltext) |
| 姜建元 王洪立 马昕 吕飞舟 夏新雷 王立勋 |
| 200040 上海, 复旦大学附属华山医院骨科, 复旦大学脊柱外科中心;200040 上海, 复旦大学附属华山医院骨科, 复旦大学脊柱外科中心;200040 上海, 复旦大学附属华山医院骨科, 复旦大学脊柱外科中心;200040 上海, 复旦大学附属华山医院骨科, 复旦大学脊柱外科中心;200040 上海, 复旦大学附属华山医院骨科, 复旦大学脊柱外科中心;200040 上海, 复旦大学附属华山医院骨科, 复旦大学脊柱外科中心 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2011.04.002 |
| 摘要点击次数: 718 |
| 全文下载次数: 457 |
| 摘要： |
| 目的 初步探讨椎间盘造影术在腰椎多节段退变性疾病临床诊疗中的应用价值。方法 2006年9月~2010年4月，行手术治疗的伴有明显腰痛症状的腰椎多节段退变性疾病患者143例，分为2组：椎间盘造影组69例，术前对MRI检查提示椎间盘退变的椎间节段进一步行椎间盘造影检查，根据常规影像学检查以及椎间盘造影检查结果选择手术干预节段；常规诊疗组74例，术前仅根据常规影像学检查结果选择手术干预节段。对所有手术干预节段行改良经椎间孔腰椎椎体间融合术。随访并比较2组患者术前及术后3个月、6个月、12个月Oswestry功能障碍指数（Oswestry disability index，ODI）及疼痛视觉模拟量表（visual analogue scale，VAS）评分。结果 椎间盘造影组及常规诊疗组分别有64例、71例患者完成了至少12个月的系统随访。2组患者术后3个月、6个月及12个月的ODI、VAS评分较术前均有好转；但椎间盘造影组术后3个月、6个月及12个月ODI、VAS评分明显优于常规诊疗组，差异有统计学意义（P<0.05）。结论 对伴有明显腰痛症状的腰椎多节段退变性疾病患者，椎间盘造影术具有良好的临床应用价值；在良好掌握临床适用范围及操作技术的基础上，不失为常规影像学检查的一种有益补充。 |
| 关键词：腰椎 椎间盘移位 椎管狭窄 脊柱滑脱 腰痛 脊髓造影术 外科手术 |
| Clinical application of discography in diagnosis and treatment of multi-segmental lumbar degenerative diseases Fulltext |
| JIANG Jian-yuan WANG Hong-li MA Xin LÜ Fei-zhou XIA Xin-lei WANG Li-xun |
| Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai 200040, China;Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai 200040, China;Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai 200040, China;Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai 200040, China;Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai 200040, China;Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai 200040, China |
| Fund Project: |
| Abstract: |
| Objective To explore of clinical value of discography in diagnosis and treatment of multi-segmental lumbar degenerative diseases. Methods From September 2006 to April 2010, a total of 143 patients with multi-segmental lumbar degenerative diseases accompanied by low back pain were divided into 2 groups: 69 patients (Discography group) underwent discography examination and conventional radiographic examination; based on the findings the selected segments were subjected to surgical intervention. The other 74 patients (Conventional treatment group) only received routine imaging examination, and surgical intervention segments were chosen accordingly. Modified transforaminal lumbar interbody fusion was used to treat all the segments. The patients were followed up and Oswestry disability index (ODI)and visual analogue scale (VAS)scores were compared between the 2 groups preoperatively and at postoperative 3 months, 6 months and 12 months. Results Sixty-four patients in discography group and 71 in conventional treatment group were followed up for at least 12 months. The ODI and VAS scores of the both groups were improved after 3 months, 6 months and 12 months compared with those pre-operation. The follow-up results also showed that the ODI and VAS scores in discography group were significantly superior to those of the conventional treatment group(P<0.05). Conclusion Discography has a good clinical value for multi-segmental lumbar degenerative diseases patients with obvious low back pain. With full understanding of the clinical indications and good operation techniques, discography is a useful supplement for conventional imaging. |
| Keywords:Lumbar vertebrae Intervertebral disk displacement Spinal stenosis Spondylolysis Low back pain Myelography Surgical procedures, operative |
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