摘要
目的:分析经皮椎间孔镜治疗单节段腰椎间盘突出症术后复发的相关因素。方法:2016年1月至2019年12月共纳入患者357例,其中男212例,女145例;平均年龄(44.76±16.21)岁,60岁以上91例;随访(25.33±9.48)个月。术前记录性别、年龄、体质量指数、腰椎间盘突出类型、手术节段、Modic改变、突出位置、Pfirrmann分级、高血压病、糖尿病、高血脂、饮酒、吸烟等,术后记录椎间活动度、活动强度、卧床时间等,定期观察,记录复发的详细情况。采用单因素及多因素分析来评估术后复发的高危因素。结果:357例中术后复发29例,复发率为8.12%。单因素分析显示复发组体质量指数、腰椎间盘突出类型、糖尿病、吸烟、术后椎间活动度、术后活动强度、术后卧床时间等变量均高于未复发组。多因素分析显示体质量指数高(OR=4.889)、腰椎间盘突出型(OR=4.304)、糖尿病(OR=3.819)、术后椎间活动度大(OR=5.555)、术后卧床时间短(OR=2.751)是腰椎间盘突出症经椎间孔镜微创手术术后复发的高危因素。结论:体质量指数高、腰椎间盘突出型、糖尿病、术后椎间活动度大、术后卧床时间短是复发的危险因素。
Objective:To analyze the recurrence factors of single-segment lumbar disc herniation after percutaneous transforaminal endoscopy.Methods:A total of 357 patients were enrolled from January 2016 to December 2019,including 212 males and 145 females;the average age was(44.76±16.21)years old,and 91 cases were over 60 years old;the average follow-up time was(25.33±9.48)months.The patient’s gender,age,body mass index(BMI),type of lumbar disc herniation,surgical segment,Modic changes,herniated position,pfirrmann classification,hypertension,diabetes,hyperlipidemia,alcohol consumption,smoking habit,etc were recorded before surgery.After the surgery,the degree of postoperative movement,activity intensity,period of bed rest,and disease recurrence were documented.Lastly,univariate and multivariate analysis were used to assess high-risk factors for postoperative disc herniation recurrence.Results:Among the 357 cases examined,29 cases recurred after surgery,eliciting a recurrence rate of 8.12%.Based on the univariate analysis,BMI,type of lumbar disc herniation,diabetes,smoking habit,postoperative intervertebral mobility,postoperative activity intensity and postoperative bed rest period significantly contributed to disease recurrence,as compared to the non-recurrent population.Moreover,the multivariate analysis revealed that high BMI(OR=4.889),lumbar disc herniation(OR=4.304),diabetes(OR=3.819),large postoperative intervertebral mobility(OR=5.555)and short postoperative bed rest(OR=2.751)are relatively high-risk factors for lumbar disc herniation recurrence,after minimally invasive surgery through foraminal endoscope.Conclusion:High BMI,lumbar disc herniation,diabetes,postoperative intervertebral mobility and short postoperative bed rest are risk factors for disc herniation recurrence.
作者
关月红
吴健
范胜利
沈玄霖
徐斌
沈国琪
何颖琦
GUAN Yuehong;WU Jian;FAN Shengli;SHEN Xuanlin;XU Bin;SHEN Guoqi;HE Yingqi(Changshu Second People’s Hospital,Changshu 215500,Jiangsu China)
出处
《中国中医骨伤科杂志》
CAS
2022年第2期40-44,共5页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词
经皮椎间孔镜
单节段
腰椎间盘突出症
复发
多因素分析
percutaneous transforaminal endoscopy
single segment
lumbar disc herniation
recurrence
multivariate analysis
