腰椎管狭窄症伴神经根沉降征阳性患者的疗效观察  

Surgical outcomes of lumbar spinal stenosis with positive sedimentation sign

作　　者：吕永威 郭继东[1] 李利[1] 王华东[1] 马超[1] 

机构地区：[1]解放军总医院第一附属医院骨科,北京100048

出　　处：《中国医刊》2016年第8期34-37,共4页Chinese Journal of Medicine

摘　　要：目的探讨腰椎管狭窄症伴神经根沉降征阳性患者的临床特点及疗效。方法选择2010年3月至2013年12月间具有完整临床资料的106例手术治疗腰椎管狭窄症患者进行回顾性分析。根据磁共振成像(magnetic resonance imaging,MRI)确定神经根是否沉降,分为沉降征阳性组(70例)和沉降征阴性组(36例)。比较两组患者的一般情况及术后疗效。治疗效果通过视觉模拟评分法(visual analogue scale,VAS)及Oswestry功能障碍指数问卷表(oswestry dability index,ODI)来评估。结果两组患者在腰部VAS、下肢VAS、ODI、手术时间、术中出血量、术后并发症、随访时间上的差异均无显著性(P>0.05)。在狭窄部位、狭窄节段数、狭窄程度及伴发骨质疏松症方面,沉降征阳性组和沉降征阴性组差异有显著性(P<0.05)。两组患者术后VAS及ODI均取得较好疗效(P<0.05)。沉降征阳性组患者术后腰部VAS改善程度优于沉降征阴性组患者(5.6 vs 4.2,P<0.05),ODI改善程度优于沉降征阴性组患者(26 vs 16,P<0.05),但两组患者术后下肢VAS改善程度差异无显著性(P>0.05)。随访期间均未发现严重并发症。结论腰椎管狭窄症伴神经根沉降征阳性患者预示术后疗效更好。Objective Evaluate the clinical characteristics and surgical outcomes of lumbar spinal stenosis with positive sedimentation sign on MRI examination. Method From March 2010 to December 2013, 106 cases were retrospectively analyzed in lumbar spinal stenosis for surgical treatment. Changes in clinical characteristic and the ODI and pain from baseline to final follow-up were compared between sedimentation sign positives and negatives in 106 patients. Result There were no differences in terms of back VAS, leg VAS, ODI, intraoperative time, blood loss, post-operative complications and follow-up period between the two groups（P〉0.05）. With respect to stenosis locations, stenotic levels, stenosis severity and osteoporosis,sedimentation sign positives were shown to have significant benefits to sedimentation sign negatives（P〈0.05）. All the patients have a significant improvement in VAS and ODI（P〈0.05）. The surgical treatment effect was significantly larger in the positive sedimentation sign group for back VAS（5.6 vs 4.2, P〈0.05） and ODI（26 vs 16, P〈0.05）, but no significant differences were shown between the two groups of patients with post operative lower limb VAS. No serious complications were found in all the cases during the follow-up period. Conclusion Lumbar spinal stenosis with positirenerve root sedimentation sign on MRI in patients predict a better postoperative curative effect.

关 键 词：沉降征 腰椎管狭窄症 Oswestry功能障碍指数问卷表 

分 类 号：R68[医药卫生—骨科学]