中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (17): 3163-3168.doi: 10.3969/j.issn.1673-8225.2011.17.030

• 骨与关节图像与影像 bone and joint imaging • 上一篇    下一篇

MRI影像学测量分析及Fisher’s线性判别在退变性下腰椎固定融合节段选择中的意义

杨振东，解京明，王迎松，张  颖   

  1. 昆明医学院第二附属医院骨科，云南省昆明市650101
  • 收稿日期:2010-11-09 修回日期:2010-12-24 出版日期:2011-04-23 发布日期:2011-04-23
  • 通讯作者: 解京明，硕士，主任医师，昆明医学院第二附属医院骨科，云南省昆明市650101 xiejingming@vip.163.com
  • 作者简介:杨振东★，男，1977年生，云南省陇川县人，汉族，2001年昆明医学院毕业，硕士，主治医师，主要从事脊柱外科方面的研究。 docyzd@126.com

Magnetic resonance imaging analysis and Fisher's linearity discrimination for the selection of fixed and fused segments during treatment of degenerative low lumbar spinal diseases

Yang Zhen-dong, Xie Jing-ming, Wang Ying-song, Zhang Ying   

  1. Department of Orthopedics, Second Affiliated Hospital of Kunming Medical University, Kunming  650101, Yunnan Province, China
  • Received:2010-11-09 Revised:2010-12-24 Online:2011-04-23 Published:2011-04-23
  • Contact: Xie Jing-ming, Master, Chief physician, Department of Orthopedics, Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan Province, China xiejingming@vip.163.com
  • About author:Yang Zhen-dong★, Master, Attending physician, Department of Orthopedics, Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan Province, China docyzd@126.com

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摘要：

背景：对下腰椎退变的MRI资料与老年人下腰椎退变性疾患中治疗节段选择的相关性报道较少。
目的：分析MRI对老年人下腰椎退变性疾病中固定融合节段选择的临床指导意义。
方法：选择152例退变性腰椎疾病患者，根据治疗方案分为对照组及固定融合组，对照组47例采用保守治疗，固定融合组105例均采用经腰椎后路全椎板减压、固定融合治疗。分别于治疗后3，6，12，24个月随访，对比两组治疗前后的日本骨科学会(JOA)评分，并应用Fisher判别分析方法以患者MRI影像资料建立判别函数，分析各因素与治疗节段选择的密切程度。
结果与结论：固定融合组治疗后JOA评分较治疗前有显著提高(P < 0.05)，治疗后各时间段固定融合组JOA评分均显著高于对照组(P < 0.05)。建立了MRI对老年人下腰椎退变性疾患治疗节段选择的判别函数，经检测，该组判别函数有统计学意义。提示MRI对老年人下腰椎退变性疾患治疗节段选择的判别函数能够有效辅助对治疗节段的诊断和判别分类，有助于制定良好的个体化治疗方案，选择合理的融合固定节段。

关键词: 退变性腰椎疾病, MRI, 疗效评定, 判别分析, 判别函数

Abstract:

BACKGROUND: Studies addressing MRI data and treated segment selection during the treatment of senile lumbar degenerative diseases are rare.
OBJECTIVE: To investigate the clinical significance of the MRI in the selection of fixed and fused segments for treatment of degenerative low lumbar spinal diseases in the elderly.
METHODS: The clinical data of 152 patients with lumbar degenerative diseases were divided into two groups: operation group and control group. They were followed up for 3, 6, 12, 24 months post treatment. Clinical function of pre and post-treatment of all the cases were determined by using Japanese Orthopaedic Association (JOA) score. The JOA score between the operation group and control group was compared. And using discriminate analysis, we studied the change of MRI, tried to find out the clinical significance of MRI in the selection of treated segment during the treatment of degenerative low lumbar spinal diseases.
RESULTS AND CONCLUSION: JOA score was significantly improved post operation in the operation group (P < 0.05). Compared to the control group, JOA score was significantly higher in the operation group (P < 0.05). Discriminant Functions were established depending on the analysis of clinical and imaging information by using statistical software, and proved whose have statistical significance.　Discriminant functions were effective to distinguish degenerative low lumbar spinal diseases and institute individualization operation project and choice possible treated segment and gain all-right clinical outcome.

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