| Background And ObjectiveLumbar spinal stenosis is a common disease in Department of orthopedics, refers to the spinal canal, nerve root canal, intervertebral foramen (developmental) with congenital or acquired factors (degeneration, trauma, instability and other) caused by bony or fibrous connective tissue abnormalities, causes the dural sac, the nerve root and the pony tail nerve compression syndrome caused by one or more of the lumen diameter of one or more of the single plane or plane, except for simple lumbar disc herniation and space occupying lesions. The cause of the disease is very complicated, which can be divided into primary lumbar spinal stenosis and secondary lumbar spinal stenosis. Primary lumbar spinal stenosis including idiopathic achondroplasia and lumbar spinal stenosis. Secondary spinal stenosis including degenerative lumbar spinal stenosis caused by traumatic spondylolisthesis, spinal fractures, fracture dislocation, Paget, iatrogenic lumbar canal stenosis, which is the most common degenerative lumbar spinal stenosis. At present, its diagnosis mainly depends on the clinical manifestation and imaging examination of the patient. The CT examination can show the bony canal in good appearance, facet joint morphology, degree of hypertrophy of ligamentum flavum, intervertebral disc herniation, which accurately determine the location of stenosis, the degree, morphology, and the spinal cord and nerve root compression. In this study, we analyzed the preoperative CT data and the intraoperative findings, to evaluate the significance of CT in the diagnosis of lumbar spinal stenosis and the selection of the operative approach for percutaneous endoscopic decompression.MethodsFrom June 2010 to June 2014 in our hospital surgical treatment of lumbar spinal stenosis in 286 cases, Among them, male 172, female 114, average age is 35.71+ 13.03 (19-66) years old, average course of disease is 48.07+ 10.36 months (30-72 months). The patients included in the study had typical clinical manifestations. All patients underwent CT examination before operation. After scanning, we choose the central section of intervertebral disc and pedicle notch to measure, The type of lumbar disc herniation in patients with surgery was compared with that of preoperative CT.,and the consistency between the two was analyzed. The consistent rate of CT operation:the results of surgical exploration were compared with those of preoperative CT in patients with lumbar spinal stenosis, the number of cases with complete or basically consistent with preoperative CT diagnosis. On the part of patients with lumbar spinal stenosis underwent percutaneous spine endoscopic interlaminar approach surgery.Results286 cases of patients with lumbar spinal stenosis, preoperative CT diagnosis for central lumbar spinal canal stenosis in 62 cases (62/286; 21.7%).51 cases of lateral recess stenosis of lumbar spinal canal stenosis (51/286; 17.8%).34 cases of lumbar spinal canal stenosis with nerve root canal (34/286; 11.9%). Mixed type (i.e., the above two or three lesions were present) in 139 cases (139/286; 48.6%). All patients were treated by surgery, and found:58 cases of central lumbar spinal canal stenosis (58/286; 20.3%). Lateral recess with spinal stenosis in 42 cases (42/286; 14.3%).Nerve root canal stenosis 30 cases of lumbar spinal stenosis (30/286; 10.5%). Mixed type (i.e., the above two or three lesions were present) in 157 cases (157/286; 54.9%). Among them there were 18 cases of preoperative CT diagnosis and operation of the prominent type does not match, CT typing and surgical compliance rate was 93.7%. The implementation of percutaneous endoscopic treatment in patients with spinal lumbosacral pain, leg pain, intermittent claudication and other symptoms, clinical curative effect is satisfactory.ConclusionLumbar spinal canal stenosis CT type high diagnostic accuracy, an important supplementary means for the diagnosis of lumbar spinal stenosis and its clinical significance is very high for minimally invasive spine surgery options. |
PDF Full Text Request