Percutaneous Disc Decompression with Nucleoplasty–Volumetry of the Nucleus Pulposus Using Ultrahigh-Field MRI 英文参考文献.docVIP

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Percutaneous Disc Decompression with Nucleoplasty–Volumetry of the Nucleus Pulposus Using Ultrahigh-Field MRI 英文参考文献.doc

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Percutaneous Disc Decompression with Nucleoplasty–Volumetry of the Nucleus Pulposus Using Ultrahigh-Field MRI 英文参考文献

PercutaneousDiscDecompressionwithNucleoplasty– VolumetryoftheNucleusPulposusUsingUltrahigh-Field MRI RichardKasch1*,BirgerMensel2,FlorianSchmidt1,WolfDrescher3,RalfPfuhl4,SebastianRuetten5, HarryR.Merk1,RalphKayser1 1ClinicandOutpatientClinicforOrthopedicsandOrthopedicSurgery,UniversityMedicineGreifswald,Greifswald,Germany,2DepartmentofDiagnosticRadiologyand Neuroradiology, University Medicine Greifswald, Greifswald, Germany, 3Department of Orthopedic and Trauma Surgery, RWTH Aachen University, Aachen, Germany, 4LeibnitzInstitute forFarmAnimal Biology,Dummerstorf, Germany,5DepartmentofSpineSurgeryandPainTherapy,CenterforOrthopedicsandTraumatology,St. Anna-HospitalHerne,Herne,Germany Abstract Purpose:Toevaluatechangesinnucleuspulposusvolumeasapotentialparameterfortheeffectsofdiscdecompression. Methods:Fifty-twodiscs(T8toL1)wereextractedfrom26pigsandseparatedintothoracic(T8toT11)andthoracolumbar discs(T12toL1).Thediscswereimagedusing7.1Teslaultrahigh-fieldmagneticresonanceimaging(MRI)withacquisition of axial T2-weighted turbo spin-echo sequences for determination of baseline and postinterventional nucleus pulposus volumes. Volumes were calculated using OsiriXH (). After randomization, one group was treatedwithnucleoplasty,whiletheplacebogroupwastreatedwithanidenticalprocedurebutwithoutcoblationcurrent. ThereadersanalyzingtheMRimageswereblindedtothekindofprocedureperformed.Baselineandpostinterventional volumeswerecomparedbetweenthenucleoplastyandplacebogroup. Results: Average preinterventional nucleus volumewas 0.799 (SD: 0.212)ml.Postinterventional volume reduction in the nucleoplastygroupwassignificantat0.052(SD:0.035)mlor6.30%(p,0.0001)(thoracicdiscs)and0.082(SD:0.042)mlor 7.25% (p=0.0078) (thoracolumbar discs). Nucleoplasty achieved volume reductions of 0.114 (SD: 0.054) ml or 14.72% (thoracic)and0.093(SD:0.081)mlor11.61%(thoracolumbar)comparedwiththeplacebogroup. Conclusions:Nucleoplastysignificantlyreducesthoracicandthoracolumbarnucleuspulposusvolumesinporcine