摘要
目的:探讨颈椎病患者突出椎间盘MRI测量的临床意义。方法:回顾分析99例接受颈椎前路间盘摘除植骨融合手术的颈椎病患者的临床资料,其中硬膜外型椎间盘突出18例,非硬膜外型椎间盘突出81例。测量MRI横断面椎间盘突出层面的椎间盘前后径、椎体前后径、椎管前后径、椎管最小径,算出椎管侵占率和椎管矢状径比减小值,对硬膜外型椎间盘突出和非硬膜外型椎间盘突出的两组病例行统计学分析。结果:两组数值间有统计学差异,硬膜外型椎间盘突出椎管侵占率﹥0.45,椎管矢状径比减小值﹥0.23,非硬膜外型椎间盘突出椎管侵占率﹤0.58,椎管矢状径比减小值﹤0.39。结论:颈椎病患者突出椎间盘的MRI测量有助于术前评估是否为硬膜外型椎间盘突出,当椎管侵占率>0.45,椎管矢状径比减小值>0.23,可疑是硬膜外型椎间盘突出,要求仔细检查后纵韧带是否破损;当椎管侵占率>0.58,椎管矢状径比减小值>0.39,可诊断为硬膜外型椎间盘突出,要求切除后纵韧带,取出椎管内的椎间盘。
Objective:To discuss the clinical significance of MRI measurement of patients with cervical disc protrusion/extrusion.Method:MRI of99patients who had cervical disc protrusion/extrusion and underwent an-terior discectomy were analyzed retrospectively.The patients were divided into epidural cervical disc extrusion(ECDE)group and non-ECDE group by the confirmation of disc protrusion or extrusion during the operation.The sagittal diameter of disc,vertebral body,spinal canal and minimal canal(spinal cord)were measured.The occupation ratio of spinal canal(OR)and decrease of Torg ratio(DTR)were calculated and analyzed.Result:There were significant differences in OR and DTR between ECDE group and non-ECDE group.In ECDE group,OR>0.45,DTR>0.23.In non-ECDE group,OR<0.58,DTR<0.39.Conclusion:ECDE should be consid-ered when OR>0.45,or DTR>0.23.The breakage of posterior longitudinal ligament should be detected to find whether epidural disc extrusion exists.ECDE should be diagnosed when OR>0.58or DTR>0.39,its posterior longitudinal ligament must be incised and extruded disc material should be removed completely.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2004年第3期147-149,共3页
Chinese Journal of Spine and Spinal Cord
