肥胖与腰椎间盘突出症术后腰腿痛的相关性研究  

The correlation between obesity and low back pain after lumbar disc herniation surgery

作　　者：周升新 王英振 

机构地区：[1]青岛大学医学部,青岛大学附属医院,山东省青岛市266071 [2]平邑县人民医院骨科一区,山东省平邑县273300

出　　处：《颈腰痛杂志》2018年第1期41-43,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨肥胖与腰椎间盘突出症术后腰腿痛的相关性。方法以2011-10-2016-12我院住院部收治的210例腰椎间盘突出症患者(均行外科手术治疗)为对象,收集患者一般临床资料,依据其体质量指数(BMI)值分为肥胖组(BMI≥28 kg/m^2,n=70)、超重组(24 kg/m^2≤BMI<28 kg/m^2,n=60)及对照组(18.5 kg/m^2<BMI<24 kg/m^2,n=80),纳入患者术后均行MRI检查,比较三组一般临床资料及术后腰腿痛程度[采用视觉模拟评分(VAS)评分评估],比较三组术后椎间盘退变分级(Pfirmann),采用Sperman相关性分析法分析肥胖与腰椎间盘突出症术后椎间盘退变程度及腰腿痛的关系。结果三组之间性别、年龄、病程等一般临床资料相较不具有统计学意义(P>0.05);术后三组腰腿部VAS评分由高到低排序:肥胖组>超重组>对照组,三组之间两两相较有明显差异(P<0.05);术后肥胖组L_(1-2)、L_(3-4)、L_(4-5)、L_5-S_1节段Pfirmann分级评分明显高于超重组和对照组(P<0.05);经Sperman相关性分析显示肥胖与腰椎间盘突出症术后椎间盘退变程度及腰腿痛程度均呈明显正相关,差异具有统计学意义(P<0.05)。结论肥胖与腰椎间盘突出症术后椎间盘退变程度和腰腿痛程度均呈明显正相关,临床可据此为腰椎间盘突出症患者实施合理的治疗方案。Objective To investigate the correlation between obesity and low back pain after lumbar disc herniation（LDH） surgery. Methods A total of 210 patients with LDH treated by surgery in the hospital from October 2011 to December 2016 were enrolled in the study, and their general data were collected. According to the body mass index（BMI）, the patients were divided into the obesity group（BMI ≥ 28 kg/m^2, n =70）, the overweight group（24 kg/m^2 BMI 28 kg/m^2, n =60） and the control group（18.5 kg/m^2 BMI 24 kg/m^2, n =80）. All the patients were examined by MRI. The general data and the degree of low back pain after surgery were evaluated by visual analogue scale（VAS）. The grade of intervertebral disc degeneration（Pfirmann） was compared among the three groups,and the relationship between lumbar disc degeneration and low back pain after LDH surgery was analyzed by Sperman correlation analysis. Results There were no significant differences among the three groups in general data such as gender, age and course of disease（P〈0.05）. After surgery, VAS scores of low back pain in the three groups ranging from high to low were the obesity group the overweight group the control group, and there were significant differences among three groups（P〈0.05）. Pfirmann scores of L1-2, L3-4, L4-5 and L5-S1 in the obese group were significantly higher than those in the overweight group and the control group（P〈0.05）. The Sperman correlation analysis showed that there was a positive correlation between obesity and the degree of lumbar disc degeneration and the degree of low back pain after LDH surgery（P〈0.05）. Conclusion There is a positive correlation between obesity and the degree of intervertebral disc degeneration and the degree of low back pain after LDH surgery. According to this, reasonable treatment for LDH can be carried out.

关 键 词：腰椎间盘突出症 肥胖 术后 腰腿痛 相关性 

分 类 号：R681.53[医药卫生—骨科学]