肌少症与退行性腰椎管狭窄症腰椎后路融合内固定术疗效的相关性  

Correlation Between Sarcopenia and Efficacy of Posterior Lumbar Fusion and Internal Fixation for Degenerative Lumbar Spinal Stenosis

作　　者：鲁崇高 贾杰[2] 拾一方 寇红伟[2] 尚国伟[2] 尚春风 陈松峰 刘宏建[2] LU Chonggao;JIA Jie;SHI Yifang;KOU Hongwei;SHANG Guowei;SHANG Chunfeng;CHEN Songfeng;LIU Hongjian(Department of Orthopedics,Gongyi People’s Hospital,Zhengzhou 451200,China;Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]巩义市人民医院骨科,河南郑州451200 [2]郑州大学第一附属医院骨科,河南郑州450000

出　　处：《河南医学研究》2023年第20期3674-3678,共5页Henan Medical Research

基　　金：国家自然科学基金面上项目(82172484)。

摘　　要：目的 探讨肌少症与接受后路融合内固定术的退行性腰椎管狭窄症(DLSS)患者临床疗效的相关性。方法 回顾性分析2019年1月至2021年12月郑州大学第一附属医院骨科收治的122例接受腰椎后路融合内固定开放手术的DLSS患者的临床资料,根据L3椎体平面骨骼肌指数(SMI),以SMI<24.4 cm^(2)·m^(-2)(男性)和SMI<23.3 cm^(2)·m^(-2)(女性)作为诊断阈值分为肌少症组(41例)和非肌少症组(81例)。经倾向评分匹配后,两组各有24例患者纳入对比。记录并比较两组患者术前1周、术后3个月、术后6个月及术后12个月的视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)评分。结果 术后3个月,肌少症组患者VAS评分及ODI平均评分高于非肌少症组(P<0.05);术后6个月及术后12个月两组VAS评分及ODI评分差异无统计学意义(P>0.05)。线性回归结果显示,术前全组患者SMI与术后3个月VAS和ODI评分改善率存在相关性(P<0.05)。结论 接受腰椎后路融合内固定开放手术的合并肌少症的DLSS患者术后早期手术疗效较非肌少症患者差。对肌少症患者行早期筛查并积极干预,可能有利于提高手术临床疗效。Objective To explore the correlation between sarcopenia and clinical efficacy in patients with degenerative lumbar spinal stenosis(DLSS)undergoing posterior lumbar fusion and internal fixation surgery.Methods A retrospective analysis was conducted on clinical data of 122 patients with DLSS who underwent posterior lumbar fusion and internal fixation surgery at the Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2021.Based on the L 3 vertebral plane skeletal muscle index(SMI),patients were divided into sarcopenia group(41 cases)and non-sarcopenia group(81 cases),with SMI<24.4 cm^(2)·m^(-2)(male)and SMI<23.3 cm^(2)·m^(-2)(female)as the diagnostic threshold.After propensity score matching,24 patients were included in each group for comparison.Visual analogue scale(VAS)and Oswestry disability index(ODI)scores were recorded and compared at 1 week before surgery,3 months,6 months and 12 months after surgery.Results At 3 months after surgery,the sarcopenia group had higher VAS and ODI scores than the non-sarcopenia group(P<0.05).There were no statistical differences in VAS and ODI scores between the two groups at 6 months and 12 months after surgery(P>0.05).Linear regression analysis showed a correlation between preoperative SMI and improvement rate of VAS and ODI scores at 3 months after surgery(P<0.05).Conclusion Patients with sarcopenia who undergo posterior lumbar fusion and internal fixation surgery for lumbar spinal stenosis have poorer early postoperative efficacy than non-sarcopenia patients.Early screening and intervention for sarcopenia may improve the clinical efficacy of surgery.

关 键 词：肌少症 腰椎后路手术 椎管狭窄症 疗效 

分 类 号：R687.3[医药卫生—骨科学]