后路手术治疗胸椎管狭窄症疗效及相关因素研究  

Efficacy and related factors of posterior approach in the treatment of thoracic spinal stenosis

作　　者：靳占奎[1] 徐翠香[1] 董向辉[1] 孙正明[1] 吴学元[1] 常彦海[1] JIN Zhan-kui;XU Cui-xiang;DONG Xiang-hui(Department of Orthopedics,People＇s Hospital of Shanxi,Xi＇an,Shanxi,710068,China.)

机构地区：[1]陕西省人民医院骨科,陕西西安710068

出　　处：《颈腰痛杂志》2018年第6期706-708,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的研究后路手术治疗胸椎管狭窄症的疗效并进行影响疗效的相关因素分析。方法纳入2010-02-2016-02于我院治疗的115例胸椎管狭窄症患者,均采用后路手术治疗,术后随访24个月。根据患者JOA评分进行疗效评价,分为优良组与可差组。调查两组患者性别、年龄、术前JOA评分,出血量等病历资料,采用单因素及多因素分析影响胸椎管狭窄症疗效的相因素。结果 115例中,优58例,良32例,优良率78.26%;可16例,差9例,可差率21.74%。末次随访较治疗前JOA评分显著增加,VAS评分显著降低,差异有统计学意义(P<0.05)。单因素分析显示,两组年龄、吸烟史、病变位置、病程、术前JOA评分、合并骨质疏松症差异具有统计学意义(P<0.05);Logistic回归分析显示,病程>6个月、术前JOA评分1～3分、病变位置T4～T9,均是影响疗效的独立危险因素。结论胸椎管狭窄症经后路手术能够获得良好疗效,病程>6个月、术前JOA评分1～3分、病变位置T4～T9均会影响手术疗效。Objective To study the curative effect of posterior operation in the treatment ofthoracic spinal stenosis, analyze the related factors affecting the curative effect, thus to provide atheoretical basis for improving the curative effect of thoracic spinal stenosis. Methods From February2010 to February 2016, 115 patients with thoracic spinal stenosis in our hospital were all treated byposterior approach. All patients were followed up for 24 months. According to JOA score, the patientswere divided into excellent group and poor group. The data of gender, age, preoperative JOA score,bleeding volume and other medical records of the two groups were investigated, and the relative factorsinfluencing the curative effect of thoracic spinal stenosis were analyzed by univariate and multivariateanalysis. Results In the last follow-up, 58 cases were excellent and 32 cases were good, and theexcellent and good rate was 78.26%; 16 cases were middle and 9 cases were poor, and the middle andpoor rate was 21.74%. JOA score at the final follow-up was significantly higher than before treatment,and the VAS score was significantly decreased, the difference was statistically significant （P〈0.05）.Univariate analysis showed that the differences of age, smoking history, lesion location, duration ofdisease, preoperative JOA score, combined osteoporosis and intraoperative blood loss were statisticallysignificant （P 〈0.05）. Logistic regression analysis showed that the disease course 〉6 months, thepreoperative JOA score achieved 1-3 points and lesion location located in T4-T9 were the independentrisk factors affecting the efficacy of thoracic spinal stenosis. Conclusion The clinical effect ofposterior surgery in the treatment of thoracic spinal stenosis is good. The course of disease is more than6 months, the preoperative JOA score is 1 to 3 and the lesion location T4-T9 can affect the curativeeffect.

关 键 词：椎管狭窄 胸椎 后路手术 相关因素 

分 类 号：R687.3[医药卫生—骨科学]