The Study Of The Diagnostic Value Of The Myelography Joint The CTM Examination In Degenerative Lumbar Scoliosis Spinal Stenosis

ObjectiveTo explore the diagnostic value of Myelography combined CTM in DegenerativeLumbar Scoliosis Spinal Stenosis and compare the diagnostic accuracy of Myelographycombined CTM and MRI.Method50cases with the typical clinical features of Degenerative Lumbar Scoliosis SpinalStenosis were selected from January2012to October2010and underwent preoperativelumbar spine X-ray plain film, Myelography, CTM and MRI before surgery. Hypotonicnonionic contrast medium is used and iodine content is300g/L, the dose8～10ml. Iniodinallergy test were taken before the surgery. The localization of entrance point is T3-4orT4-5in lateral decubitus position. Elevate the patients’ bed head to15～20oafter contrastagent injection. Through the distribution of contrast media，the stricture, the degree andrange of lesions, dura envelope and nerve compression parts can be displayed. Also, thedynamic contrast results in prone, lateral decubitus, double oblique positions should beobserved.1-2hours later after myelography, CT scanning is done. At last, lesion locationswere confirmed by surgery. According to the collected data, statistic analysis of the surgerycoincidence rate of the Myelography, CTM, Myelography combined CTM and MRI weredone.ResultsMyelography, CTM and MRI all showed a typical manifestation on the patients withDegenerative Lumbar Spinal Stenosis especially those high-deflection DegenerativeLumbar Scoliosis Spinal Stenosis patients. At the same time, Myelography United CTMcan not only show the normal influence factors in DLSS （Degenerative Lumbar Spinal Stenosis）such as hypertrophy of articular process and ligamentum flavum and lumbardegenerative disc herniation but also pedicle shift, nerve root compression and articularprocess subluxation, etc. The surgery coincidence rate of Myelography, CTM examination,Myelography combined CTM check and MRI are90%,94%,98%and86%；the diagnosiscoincidence rate of Myelography compared with CTM, P <0.01, the difference isstatistically significant; the Myelography United CTM diagnosis coincidence ratecompared with MRI, P <0.05, the difference is statistically significant which shows it isbetter than MRI.ConclusionMyelography combined CTM applied in the imaging diagnosis of DegenerativeLumbar Scoliosis Spinal Stenosis has great value in clinical application especially incomplex DLSS as it has higher coincident rate, lower adverse reaction rate and betterdiagnosis accuracy rate and is superior to MRI.