首页|腰椎管狭窄症内镜减压影像与临床资料的相关性

腰椎管狭窄症内镜减压影像与临床资料的相关性

Correlation between imaging and clinical data in endoscopic decompression for lumbar spinal stenosis

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[目的]探讨腰椎管狭窄症(lumbar spinal stenosis,LSS)内镜减压影像与临床资料的相关性.[方法]2020年1月—2022年8月本院对76例LSS患者行经皮经椎间孔内镜减压术.末次随访时按改良Macnab评价临床疗效将患者分组,比较患者临床与影像资料,分析末次随访影像参数与VAS评分、ODI指数的相关性.[结果]按Macnab标准,末次随访时临床结果评定为优36例,良32 例,可 8 例,此三组患者的VAS 评分[(1.3±0.2)vs(1.7±0.4)vs(2.6±0.8),P<0.001]、ODI 指数[(20.9±4.3)%vs(25.5±5.3)%vs(32.4± 3.4)%,P<0.001]、中央椎管横断面积[(169.3±18.3)mm2 vs(164.5±15.8)mm2 vs(156.4±13.4)mm2,P<0.001]、侧隐窝前后径[(5.3±0.7)mm vs(4.9±0.6)mm vs(4.2±0.4)mm,P<0.001]、椎间孔矢状面积[(90.2±9.0)mm2 vs(86.4±8.1)mm2 vs(80.5±6.8)mm2,P<0.001]、硬膜囊横断面积[(138.5±10.3)mm2 vs(134.4±9.2)mm2 vs(126.3±8.6)mm2,P<0.001]和硬膜囊最大矢状径[(21.7±4.0)mm vs(19.6±3.3)mm vs(17.9±2.8)mm,P<0.001]的差异均有统计学意义.相关分析表明:VAS评分与中央椎管横断面积(r=-0.429,P<0.001),侧隐窝前后径(r=-0.346,P<0.001),椎间孔矢状面积(r=-0.354,P<0.001),硬膜囊横断面积(r=-0.216,P=0.023)和硬膜囊最大矢状径(r=-0.254,P=0.014)均呈显著负相关;ODI评分与中央椎管横断面积(r=-0.420,P<0.001)、侧隐窝前后径(r=-0.335,P<0.001)、椎间孔矢状面积(r=-0.373,P<0.001)、硬膜囊横断面积(r=-0.213,P=0.022)和硬膜囊最大矢状径(r=-0.252,P=0.013)均呈显著负相关.[结论]LSS经皮经椎间孔脊柱内镜治疗后CT、MRI影像测量参数与临床疼痛、功能障碍评分具有显著关联.
[Objective]To investigate the correlation between imaging and clinical data in endoscopic decompression for lumbar spinal stenosis(LSS).[Methods]From January 2020 to August 2022,76 patients with LSS underwent percutaneous transforaminal endoscopic de-compression in our hospital.At the last follow-up,patients were grouped according to the clinical efficacy evaluated by modified Macnab cri-teria.The clinical and imaging data of patients were compared,and the correlation between the imaging parameters and VAS score or ODI score was analyzed.[Results]According to Macnab criteria,36 cases were excellent,32 cases were good,and 8 cases were fair at the last fol-low-up.There were significantly differences in terms of VAS score[(1.3±0.2)vs(1.7±0.4)vs(2.6±0.8),P<0.001],ODI score[(20.9±4.3)%vs(25.5±5.3)%vs(32.4±3.4)%,P<0.001],as well as the radiographic measurements including central canal cross-sectional area(CCCSA)[(169.3±18.3)mm2 vs(164.5±15.8)mm2 vs(156.4±13.4)mm2,P<0.001],lateral recess anteroposterior diameter(LRAPD)[(5.3±0.7)mm vs(4.9±0.6)mm vs(4.2±0.4)mm,P<0.001],sagittal area of the intervertebral foramen(SAIF)[(90.2±9.0)mm2 vs(86.4±8.1)mm2 vs(80.5±6.8)mm2,P<0.001],dural sac cross-sectional area(DSCSA)[(138.5±10.3)mm2 vs(134.4±9.2)mm2 vs(126.3±8.6)mm2,P<0.001]and the dural sac maximum sagittal diameter(DSMSD)[(21.7±4.0)mm vs(19.6±3.3)mm vs(17.9±2.8)mm,P<0.001].As results of correlation analysis,the VAS score was significantly negatively correlated with CCCSA(r=-0.429,P<0.001),LRAPD(r=-0.346,P<0.001),SAIF(r=-0.354,P<0.001),DSCSA(r=-0.216,P=0.023)and DSMSD(r=-0.254,P=0.014).Similarly,the ODI score proved significantly negatively correlated with CCCSA(r=-0.420,P<0.001),LRAPD(r=-0.335,P<0.001),SAIF(r=-0.373,P<0.001),DSCSA(r=-0.213,P=0.022)and DSMSD(r=-0.252,P=0.013).[Conclusion]After percutaneous transforaminal endoscopic decompression for LSS,the measured parameters of CT and MRI images are significantly correlated with clinical pain and dysfunction scores.

lumbar spinal stenosispercutaneous transforaminal endoscopic decompressionimaging parameterscurative outcome

王生伟、谈应东、陈丽娟、毛义义、运彩虹

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甘肃省酒泉市人民医院放射科,甘肃酒泉 735000

甘肃省酒泉市人民医院骨科,甘肃酒泉 735000

腰椎管狭窄症 经皮经椎间孔脊柱内镜治疗 影像学参数 疗效

2024

中国矫形外科杂志
中国残疾人康复协会 中国人民解放军第八十八医院

中国矫形外科杂志

CSTPCD北大核心
影响因子:1.521
ISSN:1005-8478
年,卷(期):2024.32(3)
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