摘要
目的探讨腰椎间盘突出症(LDH)患者微创消融术后MRI征象变化,分析MRI征象变化与微创消融术疗效的相关性。方法选取2022年1月至2024年12月于医院接受椎间盘微创消融术治疗的82例LDH患者,患者术前及术后3个月均进行MRI检查,并采用日本骨科协会下腰痛评分系统(JOA)评估腰椎功能,根据术后JOA评分改善率及复发情况将患者分为预后良好组(65例)与预后不佳组(17例)。分析不同预后情况的患者手术前后MRI征象变化,采用Pearson相关系数分析患者术后MRI参数(侧隐窝间隙、椎管径)与JOA评分的相关性,并采用受试者工作特征(ROC)曲线分析术后MRI征象变化对微创消融术疗效的预测价值。结果术后,患者JOA评分高于术前(P<0.05);MRI检查显示,术后3个月,两组侧隐窝间隙和椎管径均大于术前,且预后良好组侧隐窝间隙和椎管径均大于预后不佳组(P<0.05);患者术后侧隐窝间隙、椎管径均与术后JOA评分呈正相关(r=0.460、0.626,P<0.05);ROC曲线显示,侧隐窝间隙、椎管径及两者联合预测LDH患者微创消融术预后不佳的曲线下面积(AUC)分别为0.702、0.715、0.810,灵敏度分别为76.47%、82.35%、64.71%,特异度分别为67.69%、63.08%、93.85%,两者联合预测效能较高(P<0.05)。结论LDH患者微创消融术后行MRI检查,侧隐窝间隙及椎管径变化与手术预后密切相关,且对微创消融术疗效有较高预测价值。
Objective To investigate the changes in MRI signs of patients with lumbar disc herniation(LDH)after minimally invasive ablation and analyze the correlation between the changes of MRI signs and the therapeutic effect of minimally invasive ablation.Methods With the selection of 82 LDH patients who underwent minimally invasive disc ablation treatment in hospitals from January 2022 to December 2024,MRI examination was performed for all patients before and 3 months after surgery.In addition,the Japanese Orthopaedic Association(JOA)Low Back Pain Evaluation System was used to assess lumbar spine function.According to the improvement rate of JOA score and recurrence status after the operation,the patients were divided into the good prognosis group(65 cases)and the poor prognosis group(17 cases).With the analysis of changes in MRI signs before and after surgery in patients with different prognosis,the correlation between the postoperative MRI parameters(lateral recess space,vertebral canal diameter)of the patients and the JOA score was analyzed using the Pearson correlation coefficient.In addition,the receiver operating characteristic(ROC)curve was used to analyze the predictive value of changes in postoperative MRI signs for the efficacy of minimally invasive ablation.Results After the operation,the JOA scores of the patients were higher than those before the operation(P<0.05);MRI showed that 3 months after surgery,the lateral recess space and vertebral canal diameter in both groups were larger than before surgery,and the good prognosis group had larger lateral recess space and vertebral canal diameter than the poor prognosis group(P<0.05);The postoperative lateral recess space and spinal canal diameter of the patient were positively correlated with the postoperative JOA score(r=0.460,0.626,P<0.05);The ROC curve showed that the areas under the curve(AUC)of the lateral recess space,vertebral canal diameter,and their combination in predicting LDH patients with poor prognosis after minimally invasive ablation were 0.702,0.715,and 0.810,respectively,the sensitivities were 76.47%,82.35%,and 64.71%,and the specificities were 67.69%,63.08%,and 93.85%,respectively,with relatively high prediction efficiencies(P<0.05).Conclusion The postoperative changes in lateral recess space,vertebral canal diameter are closely related to the prognosis of LDH patients with minimally invasive ablation.Therefore,the detection of lateral recess space and vertebral canal diameter through MRI has high predictive value for the efficacy of minimally invasive ablation.
作者
谢人永
王学飞
Xie Renyong;Wang Xuefei(Nanping People's Hospital,Nanping Fujian 353000,China)
出处
《医疗装备》
2025年第13期1-4,共4页
Medical Equipment
关键词
腰椎间盘突出症
微创消融术
MRI征象
疗效
Lumbar disc herniation
Minimally invasive ablation
MRI signs
Curative effect
