摘要
目的探究经皮椎间孔镜椎间盘切除术(PTED)术治疗腰椎间盘突出症对患者疼痛、腰椎功能的影响及分析弥散张量成像(DTI)评估价值。方法选取2019年1月至2021年2月收治的腰椎间盘突出症患者50例。按照随机原则分为对照组与研究组,每组25例。对照组采取小切口椎板间开窗椎间盘髓核摘除术治疗,研究组采用PTED治疗,分别比较2组患者术前、术后疼痛程度、腰椎功能指标差异,并通过DTI对研究组患者进行评估。结果研究组患者术后治疗有效率显著高于对照组(P<0.05);不同时间节点下患者治疗有效率差异有统计学意义(P<0.05)。术后1个月、术后3个月,研究组ODI评分、VAS评分均低于对照组,JOA评分均高于对照组,术前、术后1个月,受压侧FA值均低于正常组(P<0.05);术后1个月、术后3个月2组ODI评分、VAS评分均低于术前,JOA评分均高于术前,术后3个月神经根受压侧ADC值明显低于术前,FA值明显高于术前,差异有统计学意义(P<0.05)。结论PTED术治疗腰椎间盘突出症效果显著,可有效缓解患者疼痛、改善腰椎功能,值得临床推广应用,通过DTI评估患者PTDE术后受压神经微观结构改善情况具有较高价值。
Objective To investigate the effects of percutaneous foraminal interdiscectomy(PTED)on the pain and lumbar function in patients with lumbar disc herniation and the evaluation value of diffusion tensor imaging(DTI).Methods Fifty patients with lubar intervertebral disc protrusion who were treated in our hospital from January 2019 to February 2021 were enrolled in the study,who were randomly divided into control group and research group,with 25 cases in each group.The patients in control group were treated by small-incision interplate open-window interdiscectomy,however,those in research group were treated by PTED.The differences of pain degree and lumbar functional index before and after operation were observed and compared between the two groups.Moreover the patients in research group were evaluated by diffusion tensor imaging(DTI).Results The effective rate of postoperative treatment in research group was significantly higher than that in control group(P<0.05),there were significant differences in the effective rates in different time points(P<0.05).At 1m,3m after surgery,the ODI scores and VAS scores in research group were significantly lower than those in control group(P<0.05),however,the JOA scores were significantly higher than those in control group(P<0.05).Moreover the FA values on compression side in research group were significantly lower than those in control group(P<0.05).In addition the ODI scores and VAS scores in both groups were lower than those before operation,but,JOA scores were higher than those before operation,At 3 months after operation,the ADC values on nerve root compression side were significantly lower than those before operation,however,the FA values were significantly higher than those before operation(P<0.05).Conclusion PTED surgery has significant therapeutic effects on lumbar disc herniation,which can effectively relieve patient’s pain and improve lumbar function,therefore,it is worthy of clinical application and promotion,and it is of higher value to evaluate the improvement status of compressed nerve microstructure after PTDE through DTI.
作者
李霞
刘志鹏
赵海泉
卫孟佳
杜鹏
于超
LI Xia;LIU Zhipeng;ZHAO Haiquan(Department of Radiology,Qinhuangdao Jungong Hospital,Hebei,Qinhuangdao 066000,China)
出处
《河北医药》
CAS
2022年第15期2292-2295,共4页
Hebei Medical Journal
关键词
腰椎间盘突出症
经皮椎间孔镜椎间盘切除术
疼痛
腰椎功能
影响
弥散张量成像
评估价值
lumbar disc herniation
percutaneous transforaminal endoscopic discectomy
pain
lumbar function
impact
Diffuse tensor imaging
evaluation value
