MRI辅助髓核容积测量评价ISOBAR TTL动态内固定系统对固定节段邻近椎间盘退变影响的临床研究

发布时间：2018-03-18 20:37

本文选题：ISOBAR　切入点：TTL动态内固定系统　出处：《中国修复重建外科杂志》2016年07期 　论文类型：期刊论文

【摘要】：目的探讨运用MRI检查测量固定节段邻近椎间盘髓核容积的变化,来研究ISOBAR TTL动态内固定系统对固定节段邻近椎间盘退变的影响。方法回顾分析2010年3月-2011年10月,采用ISOBAR TTL动态内固定系统手术治疗的34例单节段腰椎间盘突出症患者临床资料。男20例,女14例;年龄39~62岁,平均47.5岁。病程6~18个月,平均14个月。病变节段:L4、5 21例,L5、S1 13例。腰椎间盘突出症类型:旁中央型23例、外侧型11例。术前及术后6、12、18、24、36、48个月常规行X线片及MRI检查,采用角平分线法测量固定节段头侧邻近椎间隙高度,MRI辅助髓核容积测定法测量固定节段头侧邻近髓核容积。比较手术前后邻近节段椎间隙高度及髓核容积,评价Isobar TTL动态内固定技术对固定节段头侧邻近椎间盘退变的影响。结果术后30例获随访,均随访至48个月。手术前后各时间点间比较邻近节段椎间隙高度差异均无统计学意(P0.05);术后6、12、18个月的邻近节段髓核容积与术前比较差异无统计学意义(P0.05),但术后24、36、48个月的邻近节段髓核容积显著高于术前(P0.05)。髓核容积各数值中,术后6、12、18个月髓核高度及宽度与术前比较差异无统计学意义(P0.05),但术后24、36、48个月髓核高度较术前增大,髓核宽度较术前减少,差异均有统计学意义(P0.05);术后18、24、36、48个月髓核前后径均高于术前,比较差异有统计学意义(P0.05)。结论 ISOBAR TTL动态内固定系统对固定节段邻近椎间盘退变有一定预防或延迟其退变的作用。
[Abstract]:Objective to study the effect of ISOBAR TTL dynamic internal fixation system on the degenerative change of the adjacent intervertebral disc of fixed segment by MRI. Methods from March 2010 to October 2011, the changes of the volume of the nucleus pulposus were measured. The clinical data of 34 patients with single segment lumbar disc herniation treated by ISOBAR TTL dynamic internal fixation system were reported. There were 20 males and 14 females, the age was 3962 years (mean 47.5 years), the course of disease was 6 ~ 18 months. The average of 14 months was 14 months. There were 13 cases of L5N S1 in 521 cases of lesion segment. The types of lumbar disc herniation were: paracentric type in 23 cases, lateral type in 11 cases. X ray and MRI were performed before and after operation in 612 cases and 18 cases in 24 cases before and after operation, 48 months after operation, X ray examination and MRI examination were performed routinely. The height of the proximal intervertebral space of the fixed segment was measured by angular bisection and the volume of the adjacent nucleus pulposus was measured by MRI assisted with the measurement of the volume of the nucleus pulposus adjacent to the fixed segment, the height of the adjacent segment of the vertebral space and the volume of the nucleus pulposus were compared before and after the operation. To evaluate the effect of Isobar TTL dynamic internal fixation on the degenerative changes of the proximal intervertebral disc in the head and side of the fixation segment, 30 patients were followed up. All patients were followed up to 48 months. There was no significant difference in the height of adjacent intervertebral space between each time point before and after operation, and there was no significant difference in the volume of adjacent segments of nucleus pulposus between 612,18 months postoperatively compared with that before operation, but there was no significant difference in the volume of adjacent segments of nucleus pulposus before and after operation, but there was no significant difference in the volume of adjacent segments of nucleus pulposus before and after operation. The volume of adjacent segments of nucleus pulposus was significantly higher than that of preoperatively (P 0.05). There was no significant difference in the height and width of the nucleus pulposus between before and after operation (P 0.05), but the height and width of the nucleus pulposus increased at 2436,48 months after operation, and the width of the nucleus pulposus decreased. The difference was statistically significant (P 0.05), and the anteroposterior diameter of nucleus pulposus was significantly higher than that of preoperation at 18 ~ 24 ~ 36,48 months postoperatively. Conclusion the dynamic internal fixation system of ISOBAR TTL can prevent or delay the degeneration of adjacent intervertebral disc.
【作者单位】：重庆医科大学附属永川医院骨科;
【分类号】：R687.3

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