Magnetic Resonance Spinal Hydrography Analysis Of Lumbosacral Nerve Root Variation In Patients With Lumbar Disc Herniation Requiring Surgery

Objective: On the diagnosis of lumbosacral nerve root variation before percutaneous endoscopic spinal cord water imaging.Methods:Retrospective analysis of clinical symptoms of lumbar disc herniation and imaging non-conformity in our hospital after percutaneous endoscopic discectomy in 58 patients,Routine lumbar dynamic X,spinal orthorhombic splicing,lumbar CT、lumbar magnetic resonance and magnetic resonance imaging of spinal cord before operation,The following indicators were measured on the INFINITT software :(1)The height(Height,)of the intervertebral space was measured on L3-L4、L4-L5、L5-S1 median sagittal plane of the lumbar spine H)(2)The angle of penetration(Nerve TOOt Angle,)of the variate nerve root and the contralateral nerve root from the dural sac was measured on the coronal plane of magnetic resonance spinal cord water imaging nerve root NRA)and statistical analysis;Retrospective analysis of its clinical features,The duration of disease,preoperative and postoperative lumbar JOA score and pain score of lumbar VAS and affected limbs were compared.Results:There were 10 cases of lumbosacral nerve root variation in imaging,The discovery rate was 17.24%,There are different bone deformities in lumbosacral nerve root mutation,All variant segments were L4/5,L5/S1.Through the analysis of 5 cases of abnormal nerve root starting point(near root type),In 2 cases,the nerve root diameter variation,There were 3 cases with nerve root common root type,All of them were unilateral variation.Variant group measured L3-S1 vertebral height gradually decreased,The penetration angle of bilateral nerve root from the dura sac also decreased gradually.Course of disease was 0.34±0.31 years,For 1.86±3.83years,P<0.05,It is statistically significant.The preoperative JOA,waist VAS score and limb VAS score of the variant group were(?)±s:13.40±5.76、2.80±1.75、6.00±1.16,one week after operation,(?)±s:24.00±1.56、0.10±0.32、0.40±0.84,one month after operation,(?)±s:26.70±0.48、0.10±0.32、0.40±0.84,the preoperative JOA,waist VAS score and limb VAS score of non variant group were(?)±s:13.52±4.47、2.10±2.12、6.48±1.41,one week after operation(?)±s:22.94±1.80、0.56±1.05、0.79±1.34,one month after operation,(?)±s:27.10±1.13、0.15±0.58、0.35±1.00.There was no significant difference in preoperative JOA and VAS scores between the two groups(P>0.05),and there was no significant difference in postoperative long-term follow-up scores between the two groups(P>0.05).Conclusion:1.Magnetic resonance myelography can clearly visualize the lumbosacral plexus in a non-invasive way before operation,accurately locate the"responsible segment"of patients with lumbar disc herniation,and has high diagnostic value in finding patients with lumbosacral nerve root variation.2.Preoperative determination of the location and angle of the dural sac of the variant nerve root and a comprehensive grasp of the variant nerve root can help surgeons make an accurate operation plan before operation,avoid the occurrence of postoperative complications and improve the success rate of operation.3.Patients with lumbosacral nerve root variation are often associated with sacral fissure,vertebral epiphysis,spondylolisthesis,transitional cone and other bone deformities.