CAJ | 학술논문

目的：探讨 CT 检查对评价 CT 导引下椎间孔镜(PTED)治疗腰椎间盘突出疗效的应用价值。方法回顾性分析经 PT-ED 治疗腰椎间盘突出症40例患者的 CT 图像,测量手术前、后突出椎间盘最大后移位距离、纵轴线长度、相应区域 CT 值和计算椎间隙高度维持率。使用日本骨科学会(JOA)下腰背痛的评分标准对术前、后患者进行评分。结果PTED 前、后突出椎间盘后移位距离、纵轴线长度、CT 值分别为：(6.19±1.44)mm、(9.10±2.59)mm、(64.06±10.00)HU 和(2.73±0.95)mm、(4.62±2.49)mm、(33.60±8.40)HU；JOA 评分分别为8.75±2.69、25.23±2.03,恢复率为80.69%±11.20%。3种 CT 测量值与 JOA 评分的相关性分析中决定系数 R 2=0.79、F =96.90、P 值=0.000。手术椎间隙高度术前、后分别为(4.91±0.49)mm、(4.57±0.46)mm,与 JOA 评分的相关性分析中决定系数 R 2=0.93、F =520.43、P 值=0.000,椎间距维持率93%±3%。结论术后 CT 检查能够有效评估 PT-ED 治疗腰椎间盘突出症疗效,且具有重要临床指导意义。
목적：탐토 CT 검사대평개 CT 도인하추간공경(PTED)치료요추간반돌출료효적응용개치。방법회고성분석경 PT-ED 치료요추간반돌출증40례환자적 CT 도상,측량수술전、후돌출추간반최대후이위거리、종축선장도、상응구역 CT 치화계산추간극고도유지솔。사용일본골과학회(JOA)하요배통적평분표준대술전、후환자진행평분。결과PTED 전、후돌출추간반후이위거리、종축선장도、CT 치분별위：(6.19±1.44)mm、(9.10±2.59)mm、(64.06±10.00)HU 화(2.73±0.95)mm、(4.62±2.49)mm、(33.60±8.40)HU；JOA 평분분별위8.75±2.69、25.23±2.03,회복솔위80.69%±11.20%。3충 CT 측량치여 JOA 평분적상관성분석중결정계수 R 2=0.79、F =96.90、P 치=0.000。수술추간극고도술전、후분별위(4.91±0.49)mm、(4.57±0.46)mm,여 JOA 평분적상관성분석중결정계수 R 2=0.93、F =520.43、P 치=0.000,추간거유지솔93%±3%。결론술후 CT 검사능구유효평고 PT-ED 치료요추간반돌출증료효,차구유중요림상지도의의。
Objective To evaluate the application value of CT examination for treating lumbar disc herniation by CT-guided percu-taneous transforaminal endoscopic discectomy(PTED).Methods The CT images of 40 cases of PTED for lumbar disc herniation were retrospective reviewed.The maximum backward shift distance of herniated lumbar intervertebral disc (pre-operation and post-operation),the length of longitudinal axis,the CT value,and the retention rate of lumbar intervertebral height were measured The lower back pain of those patients (pre-operation and post-operation)were investigated by using the criteria of Japanese Orthopaedic Association (JOA)score.Results For pre-operation and post-operation,the maximum backward shift distance of herniated lumbar intervertebral disc,the length of longitudinal axis,the CT value were (6.1 9 ±1.44)mm,(9.10 ±2.59)mm,(64.06 ± 10.00)HU and (2.73±0.95)mm,(4.62±2.49)mm,(33.60 ±8.40)HU respectivily.The JOA score were 8.75 ±2.69,25.23 ±2.03,re-spectivily.The recovery rate of lumbar disc herniation was 80.69% ± 1 1.20%.As a result,R 2 =0.79,F = 96.9,P = 0.000 were found by the regression analysis about three types of CT measurements and the score of JOA.The lumbar intervertebral height (pre-operation and post-operation)were (4.91±0.49)mm,(4.57±0.46)mm,respectivily.The retention rate of lumbar intervertebral height was 93%±3%.As a result,R 2 =0.93,F =520.34,P =0.000 were found by the regression analysis about the lumbar inter-vertebral height and the score of JOA.Conclusion CT is of great value to evaluate curative effect of treating lumbar disc herniation by CT-guided PTED,which is significant for clinical application.