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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Research Article

Analysis of the Curative Effect of Diffusion Tensor Imaging-Guided Percutaneous Endoscopic Lumbar Discectomy

Author(s): Zheng Lian, Shanshan Gao and Hengwei Zhang*

Volume 19, Issue 9, 2023

Published on: 14 February, 2023

Article ID: e060223213447 Pages: 6

DOI: 10.2174/1573405619666230206113414

Price: $65

Abstract

Background: Diffusion tensor imaging (DTI), a novel method of describing nerve structure, is a special form of magnetic resonance imaging (MRI). This new imaging method can be used to locate the diseased nerve roots in lumbar disc herniation.

Objective: The objective of this study is to compare patient outcomes between single-level and doublesection percutaneous endoscopic lumbar discectomy (PELD) in the treatment of lumbar intervertebral disc herniation with single nerve root compression, where single-sided PELD is guided by magnetic resonance diffusion tensor imaging (DTI).

Methods: The clinical data of patients with lumbar intervertebral disc herniation with double compression of single nerve root symptoms in the Affiliated Hospital of Weifang Medical University from January 2019 to May 2021 were retrospectively summarized and divided into single-level percutaneous endoscopic discectomy (PELD) group after DTI localization and double-section PELD group. The operation time, intraoperative bleeding, VAS score and JOA score of the two groups were compared, as well as the preoperative and postoperative fractional anisotropy (FA) values in the DTI group.

Results: The operation time and intraoperative bleeding volume of patients in the DTI group were significantly lower than those in the double segment group, and there was no significant difference between VAS scores and JOA scores in the two groups. After the operation, the nerve root FA value of the responsible compression site of patients in the DTI group increased significantly, but it was still lower than the healthy symmetrical part.

Conclusion: The single-level PELD based on DTI has achieved a similar effect to that of the doublesegment PELD in 3 months after the operation, which can improve the FA value of the lesion nerve root. Its bleeding amount is less, and the operation time is shorter, but the efficacy of this technology still requires long-term follow-up of large samples.

Graphical Abstract

[1]
Amin RM, Andrade NS, Neuman BJ. Lumbar disc herniation. Curr Rev Musculoskelet Med 2017; 10(4): 507-16.
[http://dx.doi.org/10.1007/s12178-017-9441-4] [PMID: 28980275]
[2]
Mayer HM, Brock M. Percutaneous endoscopic lumbar discectomy (PELD). Neurosurg Rev 1993; 16(2): 115-20.
[http://dx.doi.org/10.1007/BF00258242] [PMID: 8345904]
[3]
Notohamiprodjo S, Stahl R, Braunagel M, et al. Diagnostic accuracy of contemporary multidetector computed tomography (MDCT) for the detection of lumbar disc herniation. Eur Radiol 2017; 27(8): 3443-51.
[http://dx.doi.org/10.1007/s00330-016-4686-7] [PMID: 27988890]
[4]
Janssen ME, Bertrand SL, Joe C, Levine MI. Lumbar herniated disk disease: Comparison of MRI, myelography, and post-myelographic CT scan with surgical findings. Orthopedics 1994; 17(2): 121-7.
[http://dx.doi.org/10.3928/0147-7447-19940201-07] [PMID: 8190676]
[5]
Choi KB, Lee CD, Lee SH. Pyogenic spondylodiscitis after percutaneous endoscopic lumbar discectomy. J Korean Neurosurg Soc 2010; 48(5): 455-60.
[http://dx.doi.org/10.3340/jkns.2010.48.5.455] [PMID: 21286487]
[6]
Ahn Y, Kim JU, Lee BH, et al. Postoperative retroperitoneal hematoma following transforaminal percutaneous endoscopic lumbar discectomy. J Neurosurg Spine 2009; 10(6): 595-602.
[http://dx.doi.org/10.3171/2009.2.SPINE08227] [PMID: 19558294]
[7]
Eun SS, Lee HY, Lee SH, Kim KH, Liu WC. MRI versus CT for the diagnosis of lumbar spinal stenosis. J Neuroradiol 2012; 39(2): 104-9.
[http://dx.doi.org/10.1016/j.neurad.2011.02.008] [PMID: 21489629]
[8]
Booz C, Nöske J, Martin SS, et al. Virtual noncalcium dual-energy CT: Detection of lumbar disk herniation in comparison with standard gray-scale CT. Radiology 2019; 290(2): 446-55.
[http://dx.doi.org/10.1148/radiol.2018181286] [PMID: 30615548]
[9]
Forristall RM, Marsh HO, Pay NT. Magnetic resonance imaging and contrast CT of the lumbar spine. Comparison of diagnostic methods and correlation with surgical findings. Spine 1988; 13(9): 1049-54.
[http://dx.doi.org/10.1097/00007632-198809000-00013] [PMID: 3206299]
[10]
Kuslich SD, Ulstrom CL, Michael CJ. The tissue origin of low back pain and sciatica: A report of pain response to tissue stimulation during operations on the lumbar spine using local anesthesia. Orthop Clin North Am 1991; 22(2): 181-7.
[http://dx.doi.org/10.1016/S0030-5898(20)31644-8] [PMID: 1826546]
[11]
Iversen T, Solberg TK, Romner B, et al. Accuracy of physical examination for chronic lumbar radiculopathy. BMC Musculoskelet Disord 2013; 14(1): 206.
[http://dx.doi.org/10.1186/1471-2474-14-206] [PMID: 23837886]
[12]
Kleiner JB, Donaldson WF III, Curd JG, Thorne RP. Extraspinal causes of lumbosacral radiculopathy. J Bone Joint Surg Am 1991; 73(6): 817-21.
[http://dx.doi.org/10.2106/00004623-199173060-00004] [PMID: 1830051]
[13]
Reza Soltani Z, Sajadi S, Tavana B. A comparison of magnetic resonance imaging with electrodiagnostic findings in the evaluation of clinical radiculopathy: A cross-sectional study. Eur Spine J 2014; 23(4): 916-21.
[http://dx.doi.org/10.1007/s00586-013-3164-z] [PMID: 24413775]
[14]
Assaf Y, Pasternak O. Diffusion tensor imaging (DTI)-based white matter mapping in brain research: A review. J Mol Neurosci 2008; 34(1): 51-61.
[http://dx.doi.org/10.1007/s12031-007-0029-0] [PMID: 18157658]
[15]
Le Bihan D, Mangin JF, Poupon C, et al. Diffusion tensor imaging: Concepts and applications. J Magn Reson Imaging 2001; 13(4): 534-46.
[http://dx.doi.org/10.1002/jmri.1076] [PMID: 11276097]
[16]
Jellison BJ, Field AS, Medow J, Lazar M, Salamat MS, Alexander AL. Diffusion tensor imaging of cerebral white matter: A pictorial review of physics, fiber tract anatomy, and tumor imaging patterns. AJNR Am J Neuroradiol 2004; 25(3): 356-69. [J].
[PMID: 15037456]
[17]
Hüppi P S, Dubois J. Diffusion tensor imaging of brain development[C]/seminars in fetal and neonatal medicine. WB Saunders 2006; 11(6): 489-97.
[18]
Zhang J, Zhang F, Xiao F, et al. Quantitative evaluation of the compressed L5 and S1 nerve roots in unilateral lumbar disc herniation by using diffusion tensor imaging. Clin Neuroradiol 2018; 28(4): 529-37.
[http://dx.doi.org/10.1007/s00062-017-0621-9] [PMID: 28828579]
[19]
Jones JGA, Cen SY, Lebel RM, Hsieh PC, Law M. Diffusion tensor imaging correlates with the clinical assessment of disease severity in cervical spondylotic myelopathy and predicts outcome following surgery. AJNR Am J Neuroradiol 2013; 34(2): 471-8.
[http://dx.doi.org/10.3174/ajnr.A3199] [PMID: 22821918]
[20]
Lope-Piedrafita S. Lz S. zng (DTI)[M]//zeclinical MRI.103-16. New York: Humana Press 2018.
[21]
Alexander AL, Lee JE, Lazar M, Field AS. Diffusion tensor imaging of the brain. Neurotherapeutics 2007; 4(3): 316-29.
[http://dx.doi.org/10.1016/j.nurt.2007.05.011] [PMID: 17599699]
[22]
Jones DK, Leemans A. Diffusion tensor imaging[J]. Magnetic resonance neuroimaging: Methods and protocols 2011; 127-44.
[23]
Li J, Cui H, Liu Z, et al. Utility of diffusion tensor imaging for guiding the treatment of lumbar disc herniation by percutaneous transforaminal endoscopic discectomy. Sci Rep 2019; 9(1): 18753.
[http://dx.doi.org/10.1038/s41598-019-55064-3] [PMID: 31822704]
[24]
Wu W, Liang J, Chen Y, Chen A, Wu B, Yang Z. Microstructural changes in compressed nerve roots treated by percutaneous transforaminal endoscopic discectomy in patients with lumbar disc herniation. Medicine 2016; 95(40): e5106.
[http://dx.doi.org/10.1097/MD.0000000000005106] [PMID: 27749591]

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