腰椎终板Modic退变对手术疗效影响的远期观察  

Operative effect of lumbar end plate Modic degeneration:long-term outcomes

作　　者：孟宪中[1] 曹俊明[1] 申勇[1] 孟宪国[1] 杨大龙[1] 

机构地区：[1]河北医科大学第三医院脊柱外科,石家庄050051

出　　处：《中国矫形外科杂志》2008年第9期660-662,共3页Orthopedic Journal of China

摘　　要：[目的]探讨腰椎终板Modic退变对伴有下腰痛的腰椎间盘突出症患者手术疗效的远期影响。[方法]回顾分析50例行腰椎单阶段开窗减压髓核摘除术的腰椎间盘突出症患者,分为两组,一组有腰椎终板Modic退变(A组),另一组无腰椎终板Modic退变(B组)。对其随访至少48个月,比较两组患者术后临床疗效,并评价腰椎终板Modic退变对患者术后下腰痛缓解的影响。[结果]术后两组患者坐骨神经痛症状均缓解。临床疗效优良率:A组90·48%;B组93·10%,两组比较差异无统计学意义(P>0·05)。术后VAS评分:A组21·37±7·59;B组8·34±3·78,两组比较差异有统计学意义(P<0·05)。[结论]腰椎间盘突出症患者术后下腰痛恢复情况与腰椎终板Modic退变相关,提示腰椎终板Modic退变可能是下腰痛的原因之一,对终板的观察可以更全面的评判下腰痛的发生、预后。[ Objective] To evaluate the long -term outcomes of lumbar end plate Modic degeneration for the treatment of lumbar disk herniation and lower back pain. [ Method] Fifty patients （21 with lumbar end plate Modic degeneration, 29 without） underwent vertebral plate excision and nucleus pulpose disectomy. After at last a 48 - month follow - up, the clinical results were compared between two groups. [ Result] The symptoms of sciatica of all the patients were reduced. Clinical outcome was 90.48% excellent or good in the Modic degeneration group and 93. 10% in the no - Modic degeneration group, this had not statistical significance （P 〉 0.05 ） . A statistical significance on the visual analog scale （VAS） between two groups was noted after treatment （ P 〈 0. 05 ） . [ Conclusion] There is a positive correlation between the recovery of low back pain and the severity of Modic degeneration of lumbar end plate. It suggests that degenerative end plate might be one of the causes of low back pain. The evaluation of the lumbar end plate may be useful for judging the development and prognosis of low back pain.

关 键 词：下腰痛 终板Modic退变 手术疗效 

分 类 号：R687.3[医药卫生—骨科学]