神经根沉降征四分法预测腰椎管狭窄患者疗效的临床价值  

Clinical value of the quadripartite method of nerve root settling sign in predicting the curative effect of lumbar spinal stenosis

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

机构地区：[1]衡水市第四人民医院影像科,河北衡水053000

出　　处：《川北医学院学报》2024年第7期949-952,共4页Journal of North Sichuan Medical College

基　　金：河北省衡水市科技计划项目(2021014069Z)。

摘　　要：目的:研究神经根沉降征(NRS)四分法分型预测腰椎管狭窄(LSS)患者疗效的临床价值。方法:回顾性分析181例腰椎管狭窄患者的临床资料,根据治疗方法分为手术组(n=82)和保守组(n=98),比较两组患者不同NRS分型患者治疗前后VAS评分、JOA评分及功能障碍指数ODI变化。结果:手术组和保守组不同NRS分型患者最小硬膜囊横截面积(CSA)差异均有统计学意义(P<0.05)。两组患者治疗前及治疗后12个月不同NRS分型间VAS、JOA评分、ODI指数比较,差异均有统计学意义(P<0.05)。两组各NRS分型患者VAS、JOA评分、ODI指数治疗前后差值比较,差异均有统计学意义(P<0.05)。组间两两比较:手术组阳a型、阳b型、阳c型VAS评分、JOA评分、ODI指数治疗前后差值均大于阴性;阳c型VAS评分、JOA评分、ODI指数治疗前后差值均大于阳a型(P<0.05)。保守组阴性VAS评分、JOA评分、ODI指数治疗前后差值均大于阳a型、阳b型、阳c型(P<0.05)。结论:LSS不同NRS分型患者手术治疗后症状均有所改善,提示NRS对LSS患者疗效预测有一定的参考价值。Objective:To investigate the clinical value of nerve root settling sign(NRS)quadrilateral method in predicting the curative effect of lumbar spinal stenosis(LSS).Methods:181 patients with symptomatic lumbar spinal stenosis were retrospectively analyzed,and they were divided into surgical treatment group(n=82)and conservative treatment group(n=98)according to treatment methods.The changes of pain VAS score,JOA score,and oswestry dysfunction index(ODI)were compared between the two groups of patients with different NRS classifications before and after treatment.Results:The minimal cross-sectional area(CSA)of the dural sac in patients with different types from two groups showed statistically significant differences(P<0.05).There were significant differences in the VAS,JOA scores,and ODI between the two groups before treatment and 12 months after treatment(P<0.05).The comparison of the changes in VAS,JOA scores,and ODI index between the surgical and conservative groups twelve months after treatment showed significant differences(P<0.05).Upon intergroup comparison,the improvement in VAS score,JOA score,and ODI index for the positive a,b,and c types in the surgical group were all greater than those for the negative types,the improvement for the positive c type was greater than that for the positive a type,with significant differences(P<0.05).In the conservative group,the improvement in VAS score,JOA score,and ODI index for the negative type twelve months after treatment was greater than that for the positive a,b,and c types,with significant differences(P<0.05).Conclusion:The symptoms of patients with different NRS subtypes of LSS are improved after operation,suggesting that NRS has certain reference value in predicting the curative effect of LSS patients.

关 键 词：神经根沉降征 腰椎管狭窄 疗效 价值 

分 类 号：R687.3[医药卫生—骨科学]