脊神经根压迫症合并梨状肌综合征的诊疗分析  

Analysis of diagnosis and treatment for spinal nerve root compression combined with piriformis syndrome

作　　者：蒋光元[1] 罗超[1] 张文川[2] 杨敏[2] 刘鹏飞[2] 

机构地区：[1]重庆市中医院神经外科,400021 [2]上海交通大学附属新华医院神经外科,200092

出　　处：《中国微侵袭神经外科杂志》2017年第12期554-556,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的分析腰椎间盘突出脊神经根减压术后合并梨状肌综合征的影响因素及治疗方法。方法回顾性分析526例腰椎间盘突出行脊神经根减压术病人的临床资料,其中合并梨状肌综合征78例(梨状肌综合征组),无梨状肌综合征448例(无梨状肌综合征组);采用Logistic回归分析脊神经根减压术后出现梨状肌综合征的影响因素。结果两组病人性别比例、术后住院时间、术中出血量及手术时间比较,差异均无统计学意义(P>0.05),而年龄、病程、髓核突出位置及韧带增厚情况差异显著(P<0.05);经Logistic回归分析显示:年龄>50岁、病程>1年、外侧型髓核突出、黄韧带增厚是术后合并梨状肌综合征的独立危险因素(P<0.05)。结论对于年龄>50岁、病程>1年、外侧型髓核突出、黄韧带增厚的腰椎间盘突出病人行脊神经根减压术后,要警惕发生梨状肌综合征。Objective To analyze the influential factors and therapeutic method for piriformis syndrome after spinal nerve root decompression in the patients with lumbar disc herniation（LDH）.Methods Clinical data of 526 LDH patients undergoing spinal nerve root decompression were analyzed retrospectively,and who were divided into piriformis syndrome group（n = 78） and without piriformis syndrome group（n = 448）.Logistic regression analysis was used to analyze the influential factors for piriformis syndrome after spinal nerve root decompression.Results There was no significant differences in sex ratio,postoperative hospitalization time,intraoperative bleeding and operation time between the two groups（P〉 0.05）,while significant differences in age,course of disease,location of nucleus pulposus protrusion and thickening of the ligament were found between the two groups（P〈 0.05）.Logistic regression analysis showed：older than 50,course more than 1 year,lateral protrusion of the nucleus pulposus and thickening of the ligamentum flavum were independent risk factors for piriformis syndrome after the operation（P 〈0.05）.Conclusion We should guard against the occurrence of piriformis syndrome for LDH patients with older than 50,course more than 1 year,lateral protrusion of the nucleus pulposus and thickening of the ligamentum flavum after spinal nerve root decompression.

关 键 词：椎间盘移位 压迫症 脊神经根 脊神经根减压术 梨状肌综合征 

分 类 号：R651[医药卫生—外科学]