摘要
[目的]探讨影响盘源性腰痛手术疗效的相关因素。[方法]收集2004年3月～2009年6月间经手术治疗、有完整随访资料的145例盘源性腰痛患者病例资料,采用Oswestry功能障碍指数(ODI)评估手术疗效。根据可能影响手术疗效的若干因素,如年龄、病程、MRI椎间隙后缘高信号区(HIZ)的出现、终板Modic退变、椎间盘造影压力、椎间盘封闭敏感程度、椎间盘退变程度等7个指标对手术疗效进行单因素分析,选取其中有统计学意义的指标进行Logistic回归分析。[结果]单因素分析显示患者年龄、病程、MRI椎间隙后缘高信号区(high-intensity zone,HIZ)的出现与手术疗效无明显相关(P值均>0.05);而终板Modic退变、椎间盘造影压力、椎间盘封闭敏感程度、椎间盘退变程度与手术疗效相关(P值均﹤0.05)。Logistic回归分析显示造影剂诱发一致性疼痛时压力大小及椎间盘封闭敏感性高低是影响手术疗效的独立危险因素,椎间盘退变程度是保护性因素。[结论]造影剂诱发一致性疼痛时压力大小及椎间盘封闭敏感性高低是影响手术疗效的独立危险因素。椎间盘造影压力是其中最重要的可控制性因素。椎间盘退变程度是保护性因素。
[ Objective ] To investigate the related factors affecting the operative effect on discogenic low back pain. [ Methods] A retrospective analysis was made on 145 patients with discogenic low back pain who underwent operation and had complete follow - up data from March 2004 to June 2009. The operative effect was assessed according to Oswestry Disability Index （ODI） . Firstly, single factor analysis was used in 7 clinical variables which might affect the effect of the surgery, including age, course of disease, high - intensity zone （ HIZ）, Modic changes, discography pressure, sensitive degree to discoblock, de- gree of lumbar disc degeneration. Then, multivariate logistic regression analysis was applied to the indexes with statistical signifi- cance. [ Results] Single factor analysis showed that age, course of disease, high -intensity zone （HIZ） were not significantly correlated with operative effect （P 〉 0. 05） . While Modic changes, discography pressure, sensitive degree to discoblock, de- gree of lumbar disc degeneration were significantly correlated with operative effect （ P 〈 0. 05 ） . Multivariate logistic regression analysis showed that discography pressure and sensitive degree to discoblock were two independent risk factors influencing the op- erative effect. The degree of disc degeneration was the protective factor. [ Conclusion ] Discography pressure and sensitive de- gree to discoblock are two independent risk factors of the surgery effect in discogenic low back pain. Of which, discography pres- sure is the most important controllable factor. The degree of disc degeneration is the protective factor.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2012年第17期1546-1550,共5页
Orthopedic Journal of China
