椎板切除术对腰骶脑脊液容量的影响:一项回顾性磁共振成像研究。

IF 1.1 4区 医学 Q3 ANESTHESIOLOGY Anaesthesia and Intensive Care Pub Date : 2023-07-01 DOI:10.1177/0310057X231159682
Seokha Yoo, Yeji Han, Youngwon Kim, Sun-Kyung Park, Young-Jin Lim, Jin-Tae Kim
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引用次数: 0

摘要

脑脊液容量影响脊髓麻醉阻滞高度。腰椎椎板切除术可能导致腰骶脑脊液容量增加。本研究旨在通过磁共振成像验证腰椎椎板切除术患者腰骶脑脊液容量大于正常腰椎解剖结构患者的假设。回顾性分析147例L2及以下椎板切除术患者(椎板切除术组)和115例无脊柱手术史患者(对照组)的腰骶椎磁共振图像。测量并比较两组腰骶部L1-L2椎间盘水平和硬脑膜囊末端之间的脑脊液体积。椎板切除术组和对照组腰骶脑脊液容量的平均(标准差)分别为22.3 (7.8)ml和21.1 (7.4)ml(平均差1.2 ml;95%置信区间-0.7 ~ 3.0 ml;p = 0.218)。在预先指定的亚组分析中,根据椎板切除术的数量,接受两个以上椎板切除术的患者与接受两个椎板切除术的患者(n = 40, 20.7 (5.6) ml)相比,腰骶脑脊液容量略大(n = 17, 30.5 (13.5) ml);P = 0.014)或一级椎板切除术(n = 90, 21.4 (6.2) ml;P = 0.010),对照组21.1 (7.4)ml;p = 0.012)。总之,腰骶脑脊液容量在接受腰椎椎板切除术的患者和没有腰椎椎板切除术史的患者之间没有差异。然而,接受两个以上椎板切除术的患者腰骶脑脊液体积略大于接受较少范围椎板切除术和没有腰椎手术史的患者。需要进一步的研究来证实亚组分析的结果,并阐明腰骶部脑脊液容量差异的临床意义。
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Influence of laminectomy on the lumbosacral cerebrospinal fluid volume: A retrospective magnetic resonance imaging study.

The cerebrospinal fluid volume affects the block height of spinal anaesthesia. Laminectomy of the lumbar spine may result in increased lumbosacral cerebrospinal fluid volume. This study aimed to test the hypothesis that the lumbosacral cerebrospinal fluid volume of patients with a history of lumbar laminectomy would be larger than that of patients with normal lumbar spine anatomy using magnetic resonance imaging. Lumbosacral spine magnetic resonance images of 147 patients who underwent laminectomy at the L2 vertebrae or below (laminectomy group) and 115 patients without a history of spinal surgery (control group) were retrospectively reviewed. The lumbosacral cerebrospinal fluid volumes between the L1-L2 intervertebral disc level and the end of the dural sac were measured and compared between the two groups. The mean (standard deviation) lumbosacral cerebrospinal fluid volume was 22.3 (7.8) ml and 21.1 (7.4) ml in the laminectomy and control groups, respectively (mean difference 1.2 ml; 95% confidence interval -0.7 to 3.0 ml; P = 0.218). In the prespecified subgroup analysis according to the number of laminectomy levels, patients who underwent more than two levels of laminectomy exhibited slightly larger lumbosacral cerebrospinal fluid volume (n = 17, 30.5 (13.5) ml) compared with those who underwent two (n = 40, 20.7 (5.6) ml; P = 0.014) or one level of laminectomy (n = 90, 21.4 (6.2) ml; P = 0.010) and the control group (21.1 (7.4) ml; P = 0.012). In conclusion, the lumbosacral cerebrospinal fluid volume did not differ between patients who underwent lumbar laminectomy and those without a history of laminectomy. However, patients who underwent laminectomy at more than two levels had a slightly larger volume of lumbosacral cerebrospinal fluid than those who underwent less extensive laminectomy and those without a history of lumbar spine surgery. Further studies are warranted to confirm the subgroup analysis findings and elucidate the clinical implications of such differences in the lumbosacral cerebrospinal fluid volume.

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来源期刊
CiteScore
2.70
自引率
13.30%
发文量
150
审稿时长
3 months
期刊介绍: Anaesthesia and Intensive Care is an international journal publishing timely, peer reviewed articles that have educational value and scientific merit for clinicians and researchers associated with anaesthesia, intensive care medicine, and pain medicine.
期刊最新文献
JG Farrell and The Lung: An early description of intensive care delirium in literature. Promoting behavioural change by educating anaesthetists about the environmental impact of inhalational anaesthetic agents: A systematic review. MET call prevention. A cross-sectional study of the relationship between iron deficiency anaemia and chronic pain. Maximising environmental sustainability on the return to in-person conferencing: Report from a 2500-person anaesthesia meeting in Sydney, Australia.
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