摘要
目的探讨仰卧位腰椎MRI关节积液是否会影响不伴影像学不稳定症状性腰椎管狭窄(LSS)患者行微创减压手术的效果。方法选取我院2014年6月至2015年11月LSS行微创减压手术患者,符合MRI存在关节积液但不伴影像学不稳定。所有患者根据有无积液及积液量多少,分为无积液组、小积液组(<1.5 mm)和大积液组(≥1.5 mm)。术后随访超过2年,依据日本骨科协会治疗评分(JOA评分)、视觉模拟量表(VAS)评分及36项短表格式健康调查表(SF-36)对3组患者术后1、2年结果进行比较。结果本研究共纳入68例患者,无积液组38例;小积液组19例;大积液组11例。术后1、2年JOA评分、VAS评分及SF-36评分,3组比较无显著差异。结论 MRI腰椎小关节积液对LSS微创减压手术的结果没有明显的影响。如果动力位X片未提示腰椎节段行不稳定,小关节积液不作为考虑是否需要融合固定的因素。
Objective To discuss the effects of facet effusion detected on MRI without radiographic segmental instability on the outcome of less-invasive decompression surgery for lumbar spinal stenosis.Methods From June of 2014 to November 2015,patients with LSS who had facet effusion detected on MRI but no segmental instability on dynamic radiographs and who were followed for at least 2 years postoperatively were analyzed.They were divided into three groups on the basis of the existence and size of facet effusion:no effusion grade,small effusion grade(<1.5 mm)and large effusion grade 2(≥1.5 mm).Japanese Orthopedics Association(JOA)score,visual analog scale(VAS),and the Short-Form(SF)-36 scores were recorded preoperatively and 12 and 24 months postoperatively.Results A total of 68 cases fulfilled our investigation criteria.The number of no effusion group,small effusion group and large effusion group were 38,19,11.JOA score,VAS score and SF-36 scores did not differ significantly between the three groups in every terms.Conclusions Facet joint effusion has no effect on the outcome of minimally invasive decompression surgery for LSS.Facet effusion is not a key factor determining whether decompression alone or decompression and fusion surgery.
作者
周金军
邓琳
张烽
ZHOU Jinjun;DENG Lin;ZHANG Feng(Department of Spine Surgery,Affiliated Hospital of Nantong University,Nantong 226000,China)
出处
《实用医学杂志》
CAS
北大核心
2018年第14期2374-2376,2380,共4页
The Journal of Practical Medicine
关键词
腰椎管狭窄
磁共振
关节积液
微创
lumbar spinal stenosis
magnetic resonance imaging
facet effusion
less-invasive
