The Clinical Study Of Diffusion Tensor Technique In The Localization Of Responsible Segments Of Multi-segment Lumbar Spinal Stenosis And Guiding Surgical Treatment

Objective:To explore the advantages of diffusion tensor technique(DTI)compared with traditional MRI in the localization of responsible segments in patients with multisegment lumbar spinal stenosis and its application value in guiding surgical treatment.Methods:A total of 20 patients with multi-segmental lumbar spinal stenosis with backache and persistent or intermittent lower extremity pain but lacking typical localizing signs,who were admitted to our hospital from February 2019 to October 2019,were selected as the subjects of the observation group.Twenty subjects who underwent routine examination in our hospital during the same period were selected as the control group.Subjects in both groups underwent magnetic resonance diffusion tensor imaging and conventional MRI scanning.The values of the Fractional anisotropy(FA)and apparent diffusion coefficient(ADC)of the nerve roots in the healthy and affected sides of the observation group,as well as the FA and ADC values of the two sides of the control group were measured and statistically compared.The correlation between DTI parameters and the severity of neurological dysfunction was determined.According to the diagnosis and treatment routine,the cases with definite indications for decompression surgery were selected from all included patients with multi-segment lumbar spinal stenosis,and the surgical decompression range was determined mainly based on DTI parameter results and nerve root fiber bundle imaging results,and combined with MRI manifestations.Before and after surgery,lumbar JOA score,visual analogue score for low back pain(VAS-BP)and visual analogue score for lower limb pain(VAS-LP)were used to evaluate the surgical effect and evaluate the clinical value of DTI in guiding the segment positioning of surgical responsibility.Results:In terms of locating the responsible segments of multi-segment lumbar spinal stenosis,the FA value of the affected side in the observation group was significantly lower than that of the contralateral side,and the ADC value was significantly higher than that of the contralateral side,with statistically significant differences(P < 0.05).In the control group,FA value and ADC value of both sides showed no significant difference after statistical comparison,showing no statistical significance(P >,0.05).In terms of guiding the positioning of the segment of surgical responsibility,DTI guided the patients undergoing surgical treatment.The postoperative lumbar JOA score was significantly higher than that before surgery,while the postoperative vas-bp and vas-lp values were significantly lower than that before surgery.Conclusion:Compared with traditional MRI,magnetic resonance diffusion tensor imaging technology is more clear and accurate in the compression of lumbosacral nerve root in patients with multi-segment lumbar spinal stenosis,which has a guiding significance in guiding the surgical treatment of responsible segments in patients with multi-segment lumbar spinal stenosis.