腰椎融合术后下腰痛与腰椎前凸角的相关性研究

Correlation Studies of the Lower Back Pain and Lumbar Lordosis Angle after Lumbar Interbody Fusion Surgery

【目的】探讨腰椎融合术后下腰痛与腰椎前凸重建的相关性研究。【方法】回顾性分析2011年2月至2012年2月124例因退行性病变行腰椎融合手术患者的临床资料，其中术后随访有下腰痛的患者共32例作为观察组，无下腰痛的患者共92例作为对照组。观察两组术前、术后6周、术后3个月、6个月、12个月、24个月及末次随访时，腰椎前凸Cobb角、下腰痛VAS评分及腰椎功能障碍ODI评分；采用Pearson相关性分析检验三者之间关系。【结果】两组术前腰椎前凸Cobb角、下腰痛VAS评分及腰椎功能障碍ODI评分比较差异无统计学意义（P〉0.05）；两组术后各时间节点的腰椎前凸Cobb角、下腰痛VAS评分及腰椎功能障碍ODI评分均较术前明显改善，差异具有统计学意义（P〈0.05）；对照组术后各时间节点的腰椎前凸Cobb角均明显大于观察组，差异具有统计学意义（P〈0.05）；随着随访时间的延长，观察组患者腰椎前凸Cobb角呈逐渐降低的趋势，下腰痛VAS评分及腰椎功能障碍ODI评分呈逐渐升高的趋势；术后1年、2年及末次随访时观察组三项指标与术后6周比较差异具有统计学意义（P〈0.05）。Pearson相关性分析结果显示：观察组患者下腰痛VAS评分、腰椎功能障碍ODI评分均与腰椎前凸Cobb角之间存在线性相关性，呈负相关（r=0.702、0.682，P〈0.05）。【结论】退行性病变腰椎融合术后患者下腰痛和腰椎功能障碍与腰椎前凸角丢失有关，应尽量矫正腰椎前凸角。

【Objective】To explore the correlation between lower back pain and lumbar lordosis angle after lumbar interbody fusion surgery. 【Methods】The clinical data of the 124 cases of the patients who received lumbar interbody fusion surgery from February 2011  February 2011 were respectively analyzed, with 32 cases of patients with low back pain considered the observation group and 92 cases of patients without low back pain considered the control group. The lumbar lordosis angle, lower back pain VAS score, and lumbar dysfunction ODI score of the two groups at the time of the preoperative and postoperative 6 weeks, 3 months, 6 months ,12 months ,24 months and the time of the last followup were observed. The correlation was tested using the Pearson correlation analysis. 【Results】The preoperative lumbar lordosis Cobb Angle, low back pain VAS scores and lumbar dysfunction ODI score of the two groups had no statistical significance differences （P〉0.05）. The postoperative lumbar lordosis Cobb Angle, low back pain VAS scores and lumbar dysfunction ODI score of the two groups were obviously improved than the preoperative, had statistically significant difference （P〈0.05）; The postoperative lumbar lordosis Cobb Angle of the control group at the each time node were significantly greater than the observation group,had statistically significant difference （P〈0.05）; With longer duration of the followup,the lumbar lordosis Cobb Angle of the observation group showed a trend of gradually reducing , the low back pain VAS scores and lumbar dysfunction ODI score showed a trend of gradually rising; The three indicators of the observation group after 1 year, 2 years and at the last followup had statistically significant differences with the 6 weeks after surgery （P〈0.05）;Pearson correlation analysis results show that ： the low back pain VAS scores, lumbar dysfunction ODI score of observation group had linear correlation with lumbar lordosis Cobb Angle,show a negative correlation （r=0.702, 0.682,P〈 0.05）. 【Conclusion】The postoperative low back pain and lumbar dysfunction of the patients with degenerative diseases who received interbody fusion surgery was associated with the lumbar lordosis angle lost, should try to rectify lumbar lordosis Angle.