摘要
目的探究多裂肌横截面积(cross-sectional area,CSA)对腰椎间盘突出症患者经皮椎间孔镜手术(percutaneous endoscopic transforaminal discectomy,PETD)术后复发的预测价值。方法选取2020年4月至2021年4月在山东中医药大学附属医院接受PETD治疗的腰椎间盘突出症患者95例,所有患者术后均随访6个月,根据随访期间是否复发分为复发组(19例)和未复发组(76例)。所有患者均行MRI检查,计算多裂肌CSA及脂肪浸润程度。比较两组患者的一般资料和手术时间、术中出血量、术后并发症发生情况,以及手术前后的疼痛视觉模拟量表(visual analogue scale,VAS)评分和Oswestry功能障碍指数(Oswestry disabilityindex,ODI),分析腰椎间盘突出症患者多裂肌CSA与VAS评分、ODI的相关性,并对PETD术后复发的危险因素进行logistic回归分析,探讨术前VAS评分、ODI及多裂肌CSA对腰椎间盘突出症患者PETD术后复发的预测价值。结果复发组患者年龄、病程、体重指数、多裂肌脂肪浸润程度高于未复发组,多裂肌CSA低于未复发组,差异有显著性(P<0.05)。两组手术时间、术中出血量、术后并发症发生率比较差异均无显著性(P>0.05)。术后6个月,复发组患者VAS评分、ODI高于未复发组,差异有显著性(P<0.05)。Pearson相关分析显示,腰椎间盘突出症患者多裂肌CSA与术后6个月时的VAS评分及ODI均呈负相关(r=-0.322,P=0.002;r=-0.315,P=0.002);logistic回归分析显示,多裂肌CSA是腰椎间盘突出症患者PETD术后复发的主要影响因素。ROC曲线分析显示,术前VAS评分、ODI及多裂肌CSA联合应用对腰椎间盘突出症患者PETD术后复发具有较高的预测价值(灵敏度为86.11%,特异度为73.21%,P=0.001)。结论多裂肌CSA是腰椎间盘突出症患者PETD术后复发的主要影响因素,与VAS评分、ODI具有一定相关性;多裂肌CSA与VAS评分、ODI联合应用对PETD术后复发具有较高的预测价值。
Objective To investigate the predictive value of multifidus muscle cross-sectional area(CSA)for postoperative recurrence after percutaneous endoscopic transforaminal discectomy(PETD)in patients with lumbar disc herniation.Method A total of 95 patients with lumbar intervertebral disc herniation who received PETD treatment in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from April 2020 to April 2021 were selected.All patients were followed up for 6 months after the operation and were divided into the recurrence group(19 cases)and non-relapse group(76 cases).All patients underwent MRI examination to calculate the degree of multifidus CSA and fatty infiltration.The general data,operation time,intraoperative blood loss,postoperative complications,visual analogue scale(VAS)score and Oswestry disability index(Oswestry disability index,ODI)before and after operation were compared between the two groups.To analyze the correlation of multifidus CSA with VAS score and ODI in patients with lumbar disc herniation,and to carry out logistic regression analysis on the risk factors of recurrence after PETD.Predictive value of recurrence after PETD in patients with intervertebral disc herniation.Result The age,course of disease,body mass index/fat infiltration degree of multifidus in the recurrence group were higher than those in the non-recurrence group,and the multifidus CSA was lower than that in the non-recurrence group,with significant differences(P<0.05).Six months after operation,the VAS score and ODI of the recurrence group were higher than those of the non-recurrence group,and the difference was significant(P<0.05).Pearson correlation analysis showed that multifidus CSA in patients with lumbar disc herniation was negatively correlated with VAS score and ODI at 6 months after operation(r=-0.322,P=0.002;r=-0.315,P=0.002);Logistic regression analysis showed that multifidus CSA was the main influencing factor for PETD recurrence in patients with lumbar disc herniation.ROC curve analysis showe
作者
刘志壮
蔡余力
王晓英
崔凯莹
郝延科
Liu Zhizhuang;Cai Yuli;Wang Xiaoying;Cui Kaiying;Hao Yanke(Shandong University of Traditional Chinese Medicine,Shandong Jinan 250355,China;Department of Joint Surgery,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Shandong Jinan 250011,China;Jinan Vocational College of Nursing,Shandong Jinan 250000,China;Department of Spinal Surgery,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Shandong Jinan 250011,China)
出处
《中国医刊》
CAS
2022年第6期642-646,共5页
Chinese Journal of Medicine
基金
山东省科技计划(2018GSF119011)。
关键词
腰椎间盘突出症
多裂肌横截面积
经皮椎间孔镜手术
脂肪浸润程度
Lumbar disc herniation
Multifidus cross-sectional area
Percutaneous endoscopic transforaminal discectomy
Degree of fat infiltration
