终板炎对经皮椎间孔镜治疗腰椎间盘突出症疗效的影响  

The Effect of Modic Changes on the Treatment of Lumbar Disc Herniation by Percutaneous Endoscopic Lumbar Discectomy

作　　者：任冬杰 王羽丰[1] 林定坤[1] 李永津[2] REN Dongjie;WANG Yufeng;LIN Dingkun;LI Yongjin(The Second Clinical College of Guangzhou University of Chinese Medicine.Guangzhou 510405,China;Guangdong Province Traditional Chinese Medical Hospital,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二临床医学院,广州510405 [2]广东省中医院

出　　处：《中国中医骨伤科杂志》2020年第7期38-42,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:通过回顾性分析终板炎(Modic改变)对经皮椎间孔镜治疗腰椎间盘突出症疗效的影响。方法:选取本院在2017年1月至2018年12月期间97例经皮椎间孔镜治疗腰椎间盘突出症伴或不伴Modic改变的患者,根据腰椎核磁共振成像(MRI)分析有无终板Modic改变,分为Modic改变组和无Modic改变组,其中Modic改变组(A组)54例,无Modic改变组(B组)53例。两组病例数、男女构成比、平均年龄、病变节段差异无统计学意义(P>0.05)。分别记录两组术前及随访时的视觉疼痛模拟量表(VAS)和改良Macnab的疗效评估。结果:两组术后1 d及术后6,12个月腰痛、腿痛VAS评分均明显低于术前,差异有统计学意义(P<0.05)。术后6,12个月两组腰痛的VAS评分比较,A组的腰痛VAS评分均高于B组,差异有统计学意义(P<0.05);术后6,12个月,B组的优良率均大于A组,差异有统计学意义(P<0.05);Modic改变与经皮椎间孔镜术后复发没有明显的相关性(P>0.05)。结论:经皮椎间孔镜治疗合并Modic改变的腰椎间盘突出症是一种安全有效的技术手段,Modic改变可能会影响术后腰痛的缓解,但Modic改变不是经皮椎间孔镜术后复发的危险因素。Objective:A retrospective study to analyze the effect of Modic changes on the treatment of lumbar disc herniation(LDH) by percutaneous endoscopic lumbar discectomy(PELD). Methods:97 patients suffered LDH with or without Modic changes who were treated in our hospital from January 2017 to December 2018 were included. All patients underwent PELD treatment. According to the lumbar magnetic resonance imaging,they were divided into Modic changes group(group A with 54 cases) and no Modic changes group(group B with 53 cases). There was no significant difference in the number of cases,gender,average age,and pathological segment between the two groups(P>0.05). Visual analog scale(VAS) pain scores and modified Macnab clinical were recorded before surgery and during follow-up. Results:Postoperative VAS scores at one day at 6 and 12 months of low back pain and leg pain in the two groups were significantly lower than the preoperative one,the difference was statistically significant(P<0.05). Postoperative VAS scores of low back pain were higher in group A than it in group B at 6 and 12 months(P<0.05). The excellent and good rates in group B were higher than those in group A at 6 and 12 months after surgery(P<0.05). There was no significant correlation between Modic changes and recurrence after PELD(P>0.05). Conclusion:PELD is a safe and effective technique for the treatment of LDH with Modic changes. Modic changes may affect the relief of postoperative low back pain but is not a risk factor for recurrence after PELD.

关 键 词：腰椎间盘突出症 腰痛 终板炎 经皮椎间孔镜 

分 类 号：R681.5[医药卫生—骨科学]