| BackgroundLumbar disc herniation(lumbar disc herniation,LDH)is a common degenerative disease,which can cause back pain and lower limb radiation pain.About 9% of people are affected,which seriously limits Quality of life and ability to work of patients.The main symptoms include nerve root pain,abnormal sensation and so on.In clinical diagnosis,doctors rely more and more on imaging results,but there is a lack of relationship between imaging results and clinical symptoms,so we can not individualize the treatment.According to the current research,there are some differences in the physiological indicators and treatment methods of acute and chronic LDH patients.In the treatment of acute stage patients,rapidpain relief is the main,while in chronic stage patients,comprehensive treatment is the main,Therefore,it is urgent to analyze the imaging image of patients,clinical symptoms and signs,and judge the relationship between the imaging information of patients and LDH case classification,so that doctors can better carry out accurate individualized treatment for patients with different types ObjectiveRetrospective study to compare the imaging data of DR and CT in patients with acute and chronic lumbar disc herniation and clinical date,and provide more reference for clinical diagnosis and treatment of the disease.MethodsAccording to the criteria of inclusion and exclusion,the patients with chronic lumbar disc herniation and acute lumbar disc herniation were divided into two groups: the long course group was the chronic lumbar disc herniation group,and the short course group was the acute lumbar disc herniation group.DR and CT scanning and reconstruction of lumbar vertebrae were performed respectively,and the general data of the patients were compared,including age,sex,onset time,and so on,conduct comprehensive analysis.DR indexes included lumbar curvature,kyphosis index,sacral tilt angle,lumbosacral angle and intervertebral space height.CT indexes included nucleus pulposus density,nucleus pulposus protruding rate,nucleus pulposus condition,sagittal plane,total multi-fissure muscle area and average multi-fissure muscle thickness.The detection rates of DR and CT in each segment were analyzed.ResultIn the long course group,there were 65 patients,aged 45.4±4.7 years,36 males and29 females.The course of the disease was 7.6 ±0.6 months,There were 6 cases of L2-L3 segment,12 cases of L3-L4 segment,26 cases of L4-L5 segment,and 21 cases of L5-S1 segment.In the short course group,63 patients(age 46.7±5.3years),34 males and 29 females,the course of disease 2.1±0.3 months,6 cases of L2-L3 segment,11 cases of L3-L4 segment,25 cases of L4-L5 segment,21 cases of L5-S1 segment;There was no significant difference between the two groupsin age,gender and prominent position(P>0.05)The curvature of lumbar vertebrae in the chronicgroup was 1.56±0.41 cm,and that in the acutegroup was 1.31±0.44 cm;There was significant difference between the two groups(P=0.001).The kyphosis index in the chronicgroup was 2.01±0.55 cm,and the kyphosis index in the acutegroup was 1.45±0.37 cm;There was significant difference between the two groups(P<0.001).The sacral tilt angle in the chronicacute group was29.41±4.03°,and there was significant difference between the two groups(P=0.002);The lumbosacral angle in the chronicgroup was 131.35±6.22°,and the lumbosacral angle in the acutegroup was 127.42±5.72°.There was significant difference between the two groups(P<0.001).The height of intervertebral space was 9.55±1.21 mm in the chronic group and7.12±1.64 mm in the acutegroup(P<0.001).The CT scan of chronic LDH patients showed that the intervertebral disc was mainly central herniation,and the compression displacement of dura mater and nerve root was relatively not obvious;the density of nucleus pulposus was mainly ? 80 HU,and a fewwere greater than 80HU;the herniation rate of nucleus pulposus was 28.35% ±8.36%;most of the cases of nucleus pulposus were protruding and protruding;there was no significant difference among sagittal plane 1,2 and 3.The total area of multifida muscle is938.53 ±85.85 mm2,the average thickness of multifida muscle is 21.35 ±2.15 mm.Most of the chronic patients with acute of disease are protruding on the left or right side,and the patients can see obvious compression and displacement of dural sac and nerve root;the density of nucleus pulposus is larger than that of 80HU;the protruding rate of nucleus pulposus is 33.42 ±7.22%;the protrusion of nucleus pulposus is mainly prolapse and atrophy and adhesion;and the sagittal protrusion is biased to 2 and 3 layers.The total area of multifissure muscle was 745.28 ±73.93 mm2,the average thickness of multifida muscle was 19.63 ±1.86mm;,There was significant difference between the two groups(P < 0.05);The angle of straight leg elevation in the chronic group(62.63 ±10.56)was significantly higher than that in the acute group(53.58 ±10.92)(P < 0.05).The muscle hardness in the chronic group(1.57±0.25)was significantly lower than that in the acute group(1.67 ±0.22),and the difference was statistically significant(P < 0.05).The range of motion of the left side was slightly higher than that of the right side,and the chronic group(L: 30.42 ± 5.86;Raster 26.75 ± 4.52)was significantly higher than the acute group(L: 20.37 ± 4.21;R:18.28 ± 3.16).The difference was statistically significant(P > 0.05).ConclusionThere are significant differences in the imaging manifestations and clinical indicators of lumbar disc herniation in acute and chronic patients,which can provide valuable information in the selection of treatment methods in clinical treatment,and help doctors to formulate individualized treatmentmeasures for differentpatients. |
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