基于不同部位特异性MRI的骨质量评估对斜外侧腰椎椎间融合术后患者椎间融合器下沉的预测价值.pdf

中文摘要

基于不同部位特异性MRI的骨质量评估对斜外侧腰椎椎间融

合术后患者椎间融合器下沉的预测价值

摘要

目的：探讨基于不同部位特异性核磁共振（MRI）的骨质量评估对斜

外侧腰椎椎间融合术（OLIF）伴或不伴后路内固定术后患者椎间融合器

下沉的预测价值。

方法：我们回顾性分析了2017-2022年间接受OLIF手术患者的治疗

记录。采用术前腰椎非对比T1加权MRI测量终板骨质量（EBQ）、平均

椎体骨质量（MVBQ）和椎体骨质量（VBQ）。采用Logistic回归分析方

法，确定与椎间融合器下沉相关的因素。采用受试者操作特征曲线

（ROC）来评价基于不同部位特异性MRI的骨质量评估在预测椎间融合

器下沉中的价值。

结果：在124例接受OLIF手术的患者中，有42例（占33.9%）出现

了下沉情况。与无下沉组相比，下沉组的VBQ、MVBQ和EBQ指标均

较高。对于行单纯OLIF手术（SA-OLIF）的患者群体而言，经过logistic

回归分析发现EBQ与下沉情况显著相关（比值比=13.656；95%可信区间

=2.561-72.806；P=0.002）。使用VBQ、MVBQ、EBQ和T值来预测融

合器下沉时的曲线下面积（AUC）分别为0.684、0.683、0.745和0.685。

而在进行OLIF联合后路内固定手术（OLIF-PF）的患者群体中，logistic

回归分析显示MVBQ与下沉情况显著相关（比值比=8.301；95%可信区

间=2.064-33.385；P=0.003）。使用VBQ、MVBQ和T值来预测融合器

下沉时的AUC分别为0.757、0.774和0.685。

结论：不同部位特异性骨质量评估对OLIF患者椎间融合器下沉的预

测价值存在显著差异。在接受SA-OLIF的患者中EBQ预测椎间融合器下

沉的价值更大，而在接受OLIF-PF的患者中，推荐采用VBQ。

关键词：骨质量，椎间融合器下沉，终板骨质量，椎体骨质量，核磁

共振

1

目录

中文摘要··········································································································1

英文摘要··········································································································2

英文缩写··········································································································4

研究论文基于不同部位特异性MRI的骨质量评估对斜外侧腰椎椎间融

合术后患者椎间融合器下沉的预测价值

前言··········································································································5

材料与方法······························································································6

结果··········································································································9

讨论·······································