腰椎终板炎对经皮内镜腰椎间盘切除术后疗效及残留神经根性症状的影响  

The influence of Modic changes on the efficacy and residual radicular symptoms after percutaneous endoscopic lumbar discectomy

作　　者：高博[1] 董明岩 路燕燕 GAO Bo;DONG Ming-yan;LU Yan-yan(WardⅢ,Dept of Orthopaedics,the Second People′s Hospital of Taizhou City,Taizhou,Jiangsu 225500,China)

机构地区：[1]泰州市第二人民医院骨科三病区,江苏泰州225500 [2]锦州医科大学附属第一医院脊柱外科,辽宁锦州121000

出　　处：《临床骨科杂志》2023年第1期24-27,共4页Journal of Clinical Orthopaedics

基　　金：江苏大学临床医学科技发展基金(编号:JLY2021185)。

摘　　要：目的探讨腰椎终板炎(Modic改变)对经皮内镜腰椎间盘切除术(PELD)术后疗效及残留神经根性症状的影响。方法将66例腰椎间盘突出症患者根据手术节段是否有Modic改变分为Modic改变组(27例)和单纯椎间盘突出组(39例),均采用PELD治疗。记录并比较两组手术时间、手术前后疼痛VAS评分、JOA评分、残留神经根性症状情况。结果患者均获得随访,时间6~12个月。手术时间两组比较差异无统计学意义(P>0.05)。疼痛VAS评分、JOA评分:两组术后1 d、7 d、1个月、6个月均较术前明显改善(P<0.05),术后1 d、6个月两组比较差异均无统计学意义(P>0.05);术后7 d、1个月,疼痛VAS评分单纯椎间盘突出组均低于Modic改变组(P<0.05),JOA评分单纯椎间盘突出组均高于Modic改变组(P<0.05)。术后残留神经根性症状发生率Modic改变组高于单纯椎间盘突出组(P<0.05)。结论采用PELD治疗有Modic改变的腰椎间盘突出症患者,术后短期内恢复情况较差,Modic改变是术后残留神经根性症状的原因之一。Objective To investigate the influence of Modic changes on the efficacy and residual radicular symptoms after percutaneous endoscopic lumbar discectomy(PELD).Methods The 66 lumbar disc herniation(LDH)patients were all treated with PELD,according to whether there were Modic changes in the operative segments,they were divided into Modic change group(27 cases)and pure LDH group(39 cases).The following data were recorded and compared,including the operation time,the pre-and post-operative pain VAS,JOA scores,and the residual radicular symptoms of the two groups.Results All patients were followed up for 6~12 months after surgery,and there was no difference in the operation time between two groups(P>0.05).The pain VAS,JOA scores:which were significantly improved at 1,7 d,1,6 months postoperation in the two groups(P<0.05),and there were no statistical differences at 1 d,6 months postoperation between two groups(P>0.05);at 7 d,1 month postoperation,the pain VAS of pure LDH group were lower than the Modic change group(P<0.05),and the JOA scores of the pure LDH group were higher than the Modic change group(P<0.05).The incidence rate of residual radicular symptoms after surgery of the Modic change group were higher than the pure LDH group(P<0.05).Conclusions PELD is used to treat the LDH patients with the Modic changes,the recovery in the short-term is poorer,and Modic change is one of the causes of residual radicular symptoms after surgery.

关 键 词：MODIC改变 经皮内镜腰椎间盘切除术 腰椎间盘突出症 神经根性症状 

分 类 号：R681.57[医药卫生—骨科学] R687.3[医药卫生—外科学]