腰椎间盘突出症和腰椎管狭窄症术后下肢麻木的发生率和影响因素

The incidence and the influencing factors of postoperative residual numbness in lumbar disc herniation and lumbar canal stenosis

目的探讨腰椎间盘突出症和腰椎管狭窄症减压术后残留麻木的发生率和影响因素。方法腰椎间盘突出症和腰椎管狭窄症患者各80例,行后路减压,术后随访10天、1个月、3个月和1年。所有患者均检查神经功能和残留症状。结果腰椎间盘突出症患者,术前76.2%患者有麻木,术后10天、1月、3月和1年分别有33.7%、25.0%、22.5%和21.3%的患者下肢残留麻木,与手术年龄、神经根直径、椎间盘突出类型和椎间盘钙化有关。腰椎管狭窄症患者,术前81.3%患者有麻木,术后10天、1个月、3个月和1年分别有42.5%、38.8%、33.7%和36.3%的患者残留麻木,与病程、术前JOA评分和椎管狭窄类型有关。结论术后1年下肢残留麻木的发生率,腰椎间盘突出症为21.3%,腰椎管狭窄症为36.3%。推测腰椎间盘突出症患者神经组织的潜在恢复能力明显高于腰椎管狭窄症患者。

Objective To evaluate the incidence of postoperative residual numbness and the factors which influenced that in lumbar disc herniation （LDH）and lumbar canal stenosis （LCS）. Methods 80 patients with LCS and LDH apiece were operated by posterior decompression,and followed 10 day, 1 month,6 month and 1 year after operation. All patients were examined neurological findings and residual symptoms. Results In LDH,There were 76.2% of patients who com- plained numbness preoperatively. The incidence of residual numbness was 33.7%,25.0%,22.5% and 21.3% after 10 day, 1 month,3 month and 12 month,respectively. The factors that influenced residual numbness were operative age,nerve root diameter,herniary type and disc calcification. In LCS, there were 81.3% of patients who complained numbness preoperatively. The incidence of residual numbness was 42.5%,38.8%,36.3% and 36.3% after 10day, 1 month,3 month and 12 month,respectively. The factors that influenced residual numbness were during syndrome,JOA score before operation and the type of spinal canal stenosis. Conclusion The incidence of postoperative residual numbness was 21.3% and 36.3% in LDH and LCS after 1 year. It is speculated that the potential ability of recovery of neural tissue in lumbar disc herniation excelled that in lumbar canal stenosis.