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
王生伟 1谈应东 2陈丽娟 1毛义义 1运彩虹1
作者信息
- 1. 甘肃省酒泉市人民医院放射科,甘肃酒泉 735000
- 2. 甘肃省酒泉市人民医院骨科,甘肃酒泉 735000
- 折叠
摘要
[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.
Abstract
[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.
关键词
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Key words
lumbar spinal stenosis/percutaneous transforaminal endoscopic decompression/imaging parameters/curative outcome引用本文复制引用
出版年
2024
NETL
NSTL
万方数据