The Clinic Research Of MRI In The Selection Of Fixation And Fusion Segment Of The Degenerative Low Lumbar Spinal Diseases

Objective To investigate the clinical signifcance of the MRI in the selection of fixation and fusion segment of the degenerative low lumbar spinal diseases on the elderly.Methods The clinical datas of 152 patients with degenerative lumbar disorder were collected from 2005 to 2008. All patients were divided into two groups, the operation group and control group. The operation group was treated with posterior decompression, pedical screw system fixation and bone grafting lumbar fusion. The control group was treated with expectant treatment. They were followed up at 3, 6, 12, 24months after treatment. Clinical function of pre and post-treatment of all the cases were determined by using JOA score. The JOA score between the operation group and control group was compared. And using discriminate analysis to study the change of MRI in the therapy segment, trying to find out the clinical significance of MRI in the selection of fixation and fusion segment of the degenerative low lumbar spinal diseases.Result (1) JOA score was significantly improved post operation in the operation group. Comparing to the control group , JOA score was significantly improved post operation in the operation group. While there is not a significant improvement for JOA score post treatment in the control group. (2) Discriminant Functions were established and proved whose have statistical significant. (3) MRI has clinical significance in the selection of fixation and fusion segment in the degenerative of discus intervertebralis, articulationes zygapophysiales and end plate, but the chang of the degenerative body of vertebra has few clinical significance in the study.Conclusion (1) Discriminant functions were established depending on the analysis of clinical and imaging information by using statistical software, and proved whose have statistical significance. (2) The analysis of the degeneration of lumbar discus intervertebralis has signifcant value in the selection of fixation and fusion segment of the degenerative low lumbar spinal diseases on the elderly. The analysis of the aggregate analysis T1, T2 weighting image also has value in the selection. (3) The analysis of the degeneration of body of vertebra has little value in the selection, but the analysis of the degeneration of hypostasy body of vertebra has a few value in the discriminatory analysis in the operation segment group. (4)The analysis of the degeneration of articulationes zygapophysiales and end plate has value in the selection of fixation and fusion segment of the degenerative low lumbar spinal diseases on the elderly, and the analysis of the degeneration of upper end plate has more effective than below end plate in the operation segment group. (5) The analysis of the diference of bilateralis articular process angle has value in the selection of fixation and fusion segment of the degenerative low lumbar spinal diseases on the elderly. (6) MRI has signifcant value in the selection of fixation and fusion segment of the degenerative low lumbar spinal diseases on the elderly. Discriminant functions have value in the clinical application, but those are not the unique inclusion criteria. Aiming directly at the multiple factor of pathopoiesis feature, combineing clinical symptom , objective sign and other imageology information , discriminant functions were effective to distinguish degenerative low lumbar spinal diseases and institute individualization operation project and choice possible therapy segment and gain all-right clinical outcome.