神经根沉降征四分法分型与腰椎管狭窄症严重程度、疼痛、最小硬膜囊横截面积的相关性  

Correlation of nerve root settlement sign quartile classification with severity,pain and minimum dural sac cross-sectional area of lumbar spinal stenosis

作　　者：王芬[1] 杨利[1] 马远博 张静 李娜[1] WANG Fen;YANG Li;MA Yuanbo;ZHANG Jing;LI Na(Department of Imaging,No.4 People’s Hospital of Hengshui,Hengshui 053000,China)

机构地区：[1]河北省衡水市第四人民医院影像科,河北衡水053000

出　　处：《中国中西医结合影像学杂志》2024年第4期458-461,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：衡水市科技计划项目(2021014069Z)。

摘　　要：目的:分析神经根沉降征(NRS)四分法分型与腰椎管狭窄症(LSS)严重程度、视觉模拟疼痛量表(VAS)评分、最小硬膜囊横截面积(CSA)的相关性,探讨其对LSS的临床价值。方法:回顾性选择180例LSS患者作为研究对象,均行MRI横断面扫描;采用NRS四分法分型分为阳a型58例,阳b型55例,阳c型31型及阴型36例4组,比较4组最小硬膜囊CSA、VAS评分、Oswestry功能障碍指数(ODI)及腰椎管狭窄相关指标,分析NRS四分法分型与最小硬膜囊CSA、VAS评分、ODI的相关性。结果:4组最小硬膜囊CSA、VAS评分、ODI比较,差异均有统计学意义(均P<0.05)。最小硬膜囊CSA组间两两比较:阳a型、阳b型、阳c型均小于阴型,阳b型、阳c型均小于阳a型,阳c型小于阳b型,差异均有统计学意义(均P<0.05)。VAS评分、ODI组间两两比较:阳a型、阳b型、阳c型均大于阴型,阳b型、阳c型均大于阳a型,阳c型大于阳b型,差异均有统计学意义(均P<0.05)。各型椎管正中矢状径、侧隐窝矢状径差异均无统计学意义(均P>0.05)。NRS分型与VAS评分、ODI呈正相关(r=0.894,0.929;均P<0.001),与最小硬膜囊CSA呈负相关(r=-0.870,P<0.001)。结论:NRS四分法分型越高,LSS症状和狭窄程度越重,这对LSS的诊断和病情评估均有重要价值。Objective:To study the correlation of nerve root sedimentation sign(NRS)quartile classification with the severity,visual analogue scale(VAS)score and minimum dural sac cross-sectional area(CSA)of lumbar spinal stenosis(LSS).To explore their clinical values in LSS.Methods:A retrospective study was conducted on 180 LSS patients,who underwent MRI scan.The patients were classified into four types using the NRS quartile classification,including 58 cases in type a,55 in type b,31 in type c,and 36 in negative type.The minimum CSA,VAS score,Oswestry disability index(ODI)and LSS indexes were compared among the 4 types.The correlations between NRS quartile classification and minimum CSA,VAS score,ODI were analyzed.Results:There were significant differences in the minimum CSA,VAS score and ODI among the 4 types(all P<0.05).The minimal CSA of type a,b,c was all less than that of negative type,and that of type b,c was all less than that of type a,and that of type c was less than that of type b,the differences were statistically significant(all P<0.05).VAS score and ODI of type a,b,c were all higher than those of negative type,those of type b,c were higher than those of type a,those of type c were higher than those of type b,the differences were statistically significant(all P<0.05).There were no significant differences in the median sagittal diameter or lateral recess sagittal diameter of spinal canal of each type(all P>0.05).NRS quartile classification was positively correlated with VAS score and ODI(r=0.894,0.929,both P<0.001),and negatively correlated with CSA(r=-0.870,P<0.001).Conclusions:The higher the NRS quartile classification,the more severe the symptoms and stenosis of LSS,which is of great value for the diagnosis and evaluation of LSS.

关 键 词：神经根沉降征 四分法分型 腰椎管狭窄症 严重程度 视觉模拟疼痛评分 最小硬膜囊横截面积 

分 类 号：R681.5[医药卫生—骨科学]