患者疼痛敏感度对腰椎间盘突出症行MIS-TLIF手术疗效的影响分析  

Analysis of the effect of pain sensitivity on MIS-TLIF operation for lumbar disc herniation

作　　者：刘帅 张豪伟 韦学昌 郭阿雷 虞鑫 LIU Shuai;ZHANG Hao-wei;WEI Xue-chang;GUO A-lei;YU Xin(Department ofSpine Orthopaedics,General Hospital of Pingdingshan Shenma Medical Group,Pingdingshan,Henan 467000,China)

机构地区：[1]平煤神马医疗集团总医院脊柱骨科

出　　处：《颈腰痛杂志》2019年第6期781-783,787,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨术前疼痛敏感度对腰椎间盘突出症(lumbar disc herniation,LDH)患者行MIS-TLIF手术的疗效影响。方法自2014年7月-2016年7月,共纳入行MIS-TLIF手术治疗的72例LDH患者,依据其术前疼痛敏感性问卷(Pain sensitivity questionnaire,PSQ)评分不同,分为两组:观察组42例,PSQ评分<6.5分;对照组30例,PSQ评分≥6.5分。对比两组患者术后VAS评分和ODI指数的改善程度,并进行PSQ评分与两项疗效指标的相关性分析。结果与术前相比,两组患者末次随访时的VAS评分、ODI指数均显著改善(P<0.05);但观察组的VAS评分、ODI指数改善程度均显著大于对照组(P<0.05)。末次随访时,观察组的总优良率为90.48%,显著优于对照组的80.00%,组间差异有统计学意义(P<0.05)。经Pearson相关性检验,术后VAS评分和ODI指数的改善程度,均与患者术前PSQ评分呈明显的负相关关系(r=-0.153,r=-0.074;P<0.05)。结论疼痛敏感度对LDH患者行MIS-TLIF手术的预后可产生明显影响,若患者术前疼痛敏感度较高,其疼痛和功能障碍改善程度亦明显偏差。Objective To investigate the effect of preoperative pain sensitivity on patients with lumbar disc herniation(LDH)undergoing MIS-TLIF.Methods From July 2014 to July 2016,72 patients with LDH who underwent MIS-TLIF operation in our hospital were divided into two groups according to their preoperative Pain Sensitivity Questionnaire(PSQ)scores:observation group(42 cases)with PSQ score<6.5;control group(30 cases)with PSQ score≥6.5.The improvement of VAS score and ODI index were compared between the two groups,and the correlation between PSQ score and two therapeutic indicators was analyzed.Results Compared with before operation,the VAS score and ODI index of the two groups at the last follow-up were significantly improved(P<0.05),and the improvement of VAS score and ODI index of the observation group was significantly better than that of the control group(P<0.05).At the last follow-up,the total excellent and good rate of the observation group was 90.48%,which was significantly higher than 80%of the control group(P<0.05).Pearson correlation test showed that the improvement of VAS score and ODI index was negatively correlated with preoperative PSQ score(r=-0.153,r=-0.074;P<0.05).Conclusion Pain sensitivity has significant influence on the prognosis of LDH patients undergoing MIS-TLIF.If the preoperative pain sensitivity is high,the degree of improvement of pain and dysfunction is also significantly deviated.

关 键 词：腰椎间盘突出症 椎体间融合手术 微创 疼痛敏感度 疼痛敏感性问卷 

分 类 号：R681.53[医药卫生—骨科学] R687.3[医药卫生—外科学]