摘要
目的探讨影响经皮椎间孔镜手术治疗腰椎间盘突出症疗效的危险因素。方法选取我院骨外科行经皮椎间孔镜手术治疗的腰椎间盘突出症98例患者的临床资料,根据其术后临床效果分为优良组和可差组,对影响其术后临床效果的10种可能因素,分别采用单因素描述性分析和多因素Logistic分析方法做统计学处理,并确定危险因素。结果单因素分析发现两组在性别、手术节段、Lee分区、纤维环破裂、Modic改变等差异无统计学意义(P>0.05),在年龄、病程、外伤史、临床症状、椎间盘退变分级等比较有统计学意义(P<0.05);多因素Logistic回归分析影响因素的危险程度由高到低依次是:椎间盘退变IV级(OR=5.423)、腰腿痛并存(OR=4.678)、病程>12个月(OR=3.982)、有外伤史(OR=2.510)和年龄≥45岁(OR=1.525)。结论影响经皮椎间孔镜手术治疗腰椎间盘突出症疗效的危险因素为椎间盘退变IV级、腰腿痛并存、病程>12个月和年龄≥45岁,在临床治疗上高度重视,以期达到临床效果最优化。
Objective To discuss the risk factors of clinical effect of percutaneous lumbar disc surgery in the treatment of prolapse of lumbar intervertebral disc and matters needing attention. Methods The clinical data of 98 patients with prolapse of lumbar intervertebral disc and matters needing attention treated by percutaneous lumbar disc surgery in Department of Orthopeadic Surgery of our hospital were selected, and they were divided into excellent-effect group and poor-effect group according to the clinical effect after operation. The 10 risk factors that may affect clinical effect after operation were developed statistics processing by descriptive analysis of single factor and multi-factor Logistic analysis, and the risk factors were determined. Results The single factor analysis showed that the differences in gender,surgical segment,Lee partition,fiber ring rupture,Modic changes were not statistically significant between the two groups（P〉0.05）, and the differences in age,course of disease, history of trauma,clinical symptoms and the classification of intervertebral disc degeneration were statistically significant between the two groups （P〈0.05）.Muhivariate logistic regression analysis of factors influencing the degree of risk were ranked from high to low in order： intervertebral disc degeneration grade Ⅳ （OR=5.423）, heavier pain of low back and leg （OR=4.678）, course of disease more than 12 months（OR=3.982）,a history of trauma （OR=2.510） and age greater than or equal to 45 years （OR=1.525）. Conclusion The risk factors affecting the clinical effect of percutaneous lumbar disc surgery in the treatment of prolapse of lumbar intervertebral disc are intervertebral disc degeneration grade Ⅳ, heavier pain of low back and leg, history of trauma, course of disease more than 12 months and age greater than or equal to 45 years,which should be attached great importance to the clinical treatment in order to achieve the optimization of clinical results.
出处
《颈腰痛杂志》
2016年第6期487-490,共4页
The Journal of Cervicodynia and Lumbodynia
关键词
经皮椎间孔镜手术
腰椎间盘突出症
危险因素
percutaneous lumbar disc surgery
prolapse of lumbar intervertebral disc
risk factor
