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《ct引導(dǎo)椎間盤造影術(shù)在多節(jié)段腰椎間盤退變中的臨床價(jià)值》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在學(xué)術(shù)論文-天天文庫(kù)。
1、CT引導(dǎo)椎間盤造影術(shù)在多節(jié)段腰椎間盤退變中的臨床價(jià)值作者：薛華明，涂意輝，蔡珉巍，楊安禮【摘要】[目的]探討CT引導(dǎo)下椎間盤造影術(shù)在治療多節(jié)段腰椎間盤退變疾患中的臨床價(jià)值。[方法]2005年1月～2008年1月對(duì)28例多節(jié)段腰椎間盤退變疾患行CT引導(dǎo)下椎間盤造影術(shù)，其中男12例，女16例;年齡30～56歲，平均38.2歲。腰椎間盤退變節(jié)段：L3、4和L4、5突出9例，L4、5和L5S1突出15例，L3、4、L4、5和L5S1三節(jié)段突出4例。造影節(jié)段：28例共計(jì)92個(gè)椎間盤，L2、3間隙10例，L3、4間隙28例，L4、5間隙28例，L5S
2、1間隙26例。按照陽(yáng)性椎間盤造影的診斷標(biāo)準(zhǔn)，篩選出致痛性椎間盤(責(zé)任間盤)，對(duì)這些病變間隙行相應(yīng)的椎間融合術(shù)治療。[結(jié)果]28例患者92個(gè)間隙共篩選出32個(gè)責(zé)任間盤。VAS≥6分組中Ⅱ+Ⅲ級(jí)間盤(Dallas分級(jí))和退變間盤(Pearce分級(jí))所占的百分比明顯高于VAS<6分組(P<0.05)。手術(shù)前后ODI指數(shù)評(píng)分比較有顯著性差異(P<0.05)。隨訪12～36個(gè)月，平均25.2個(gè)月。Charles療效評(píng)定，術(shù)后優(yōu)22例(78.6%)，良5例(17.9%)，一般1例(3.6%)，差0例。所有病例均未發(fā)生與椎間盤造影有關(guān)
3、的并發(fā)癥。1例椎間融合器下沉，1例植骨融合不良，1例術(shù)后病變側(cè)伸母肌力減退，再次手術(shù)行椎弓根螺釘調(diào)整術(shù)，術(shù)后2個(gè)月肌力恢復(fù)。[結(jié)論]CT引導(dǎo)下椎間盤造影術(shù)對(duì)于多節(jié)段腰椎間盤退變疾患中責(zé)任間盤的選擇具有重要的臨床意義。12【關(guān)鍵詞】腰椎;椎間盤造影術(shù);多節(jié)段;腰椎間盤退變Clinicalvalueofdiscographyfollowedbycomputedtomographyforthetreatmentofmulti-levellumbardiscdegeneration∥XUEHua-ming,TUYi-hui,CAIMin-wei
4、,etal.DepartmentofOrthopaedics,YangpuDistrictCentralHospital,Shanghai200090,China Abstract:[Objective]Toexploretheclinicalvalueofdiscographyfollowedbycomputedtomographyforthetreatmentofmulti-levellumbardiscdegeneration.[Methods]Twenty-eightcaseswereenrolledfromJanuary200
5、5toJanuary2008.Therewere12malesand16femaleswithaverageageof38.2years，rangingfrom30to56years.ThelevelofdegenerateddiscincludedL3、4andL4、5(9cases),L4、5andL5S1(15cases),L3、4,L4、5andL5S1(4cases).ThelevelofdiscographyincludedL2、3(10cases),L3、4(28cases),L4、5(28cases),andL5S1(26
6、cases)withatotalof92discs.Thepainfuldiscs(orresponsiblediscs)werescreenedaccordingtodiagnosticcriteriaofprovocativediscographyandtreatedwithinterbodyfusion.[Results]Thirty-tworesponsiblediscswerescreenedin12totalof92discs.ODIscoresbetweenpreandpostoperationweresignificant
7、lydifferent(P<0.05).ThepercentageofGradeⅡ,Ⅲdiscs(Dallasgrade)anddegenerateddiscs(PearcegradeⅢtoⅤ)inVAS≥6groupwassignificantlyhigherthanthatinVAS<6group.Allcaseswerefollowedupfrom12to36months(mean25.2months).Theclinicalresultswereexcellentin22cases(78.6%),goodin5(17.
8、9%)andfairin1(3.6%)byCharlesscore.Allcaseshadnocomplicationsrelatedtodiscography.Onecagesubsiden
