伴Modic信号改变的腰椎滑脱手术疗效分析  

Analysis on surgical treatment efficacy of lumbar spondylolisthesis patients with modic change

作　　者：易文强 肖洪[2] 任小宝[3] 

机构地区：[1]重庆市垫江县人民医院骨科,重庆408300 [2]解放军第324医院骨科,重庆404000 [3]第三军医大学西南医院急诊部,重庆400038

出　　处：《局解手术学杂志》2015年第4期440-442,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨腰椎滑脱伴Modic改变的手术治疗疗效。方法回顾性分析2010年1月至2013年12月我院收治的45例腰椎滑脱伴Modic改变患者的临床资料,分析经腰椎间融合内固定术治疗的疗效。腰椎滑脱患者术前经X片及核磁共振成像(MRI)检查确定椎体滑脱程度和Modic分型。将患者按照滑脱程度及是否合并Modic改变分为6组:A组,Ⅱ°滑脱;B组,Ⅲ°滑脱;C组,Ⅱ°滑脱伴Modic I型;D组,Ⅱ°滑脱伴ModicⅡ型;E组,Ⅲ°滑脱伴ModicⅠ型;F组,Ⅲ°滑脱伴ModicⅡ型。患者术前和随访按视觉疼痛模拟量表(VAS)评分和Osewstry功能障碍指数评分(ODI)进行评价,数据进行统计分析,并评价治疗效果。结果所有患者在疼痛及功能障碍评分上得到不同程度的改善;各组内术后的腰腿痛评分及ODI评分与术前比较显著降低(P<0.0001);各组间腰腿痛及ODI评分的改善率无显著差异(P>0.05)。结论伴Modic征改变的腰椎滑脱患者经PLIF术治疗可获得的较为满意的临床疗效。Objective To investigate the treatment efficacy of lumbar spondylolisthesis patients with modic change. Methods The data of 45 lumbar spondylolisthesis patients with modic change were analyzed retrospectively,which were admitted into hospital from January2010 to December 2013 and received posterior lumbar interbody fusion（ PLIF） surgery. Those patients were tested by X-ray and Magnetic resonance imaging（ MRI） and confirmed the type of spondylolisthesis and Modic change. Based on the degree of spondylolysis and whether combined or not with Modic change,all the patients were divided into six groups： group A with Ⅱ grade spondylolisthesis; group B with Ⅲgrade spondylolisthesis; group C with Ⅱ grade spondylolisthesis with Modic type Ⅰ; group D with Ⅱ grade spondylolisthesis with Modic typeⅡ; group E with Ⅲ grade spondylolisthesis with Modic type Ⅰ; group F with Ⅲ grade spondylolisthesis with Modic type Ⅱ. Those patients were evaluated preoperatively and postoperatively the scores according to the Visual Analogue Scale（ VAS） and Oswestry Disability Index（ ODI） systems,the obtained data were statistically analyzed and then were used to evaluated the treatment efficacy. Results The treatment efficacy of those patients were evaluated by follow-up work based on the scores of VAS and ODI systems,the results indicated that all those patients were improved in the scores of pain and ODI at different agrees. Within groups,the scores of low back and leg pain in VAS system and ODI preoperative were all significantly lower than that of postoperative（ P〈 0. 0001）. However,there were no significant differences of those scores among groups（ P〉 0. 05）. Conclusion Those spondylolisthesis patients with Modic change could obtained satisfactory clinical efficacy after posterior lumbar interbody fusion（ PLIF） surgery.

关 键 词：腰椎滑脱 MODIC改变 PLIF术 疗效分析 

分 类 号：R681.5[医药卫生—骨科学]