术前邻近节段椎间盘退变程度与腰椎间盘突出症术后疗效评估之间的关系分析

The relationship between the degree of degeneration of intervertebral disc in adjacent segments before operation and postoperative evaluation of lumbar intervertebral disc herniation

目的探讨邻近节段椎间盘退变程度对腰椎间盘突出症手术疗效的影响。方法:对腰椎间盘突出症手术治疗患者76例进行邻近节段椎间盘退变程度Pfirrmann分级,比较不同分级的患者治疗前后腰背痛、下肢疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)以及改良Macnab疗效。结果:随着Pfirrmann分级的增加,治疗后12个月时的腰背VAS评分和ODI指数显著增加(P<0.05);治疗后12个月时Ⅳ级患者的下腰VAS评分显著高于其他3组(P<0.05)。Ⅲ级与Ⅳ级患者疗效优良率显著低于Ⅰ级与Ⅱ级患者(P<0.05)。结论:术前临近节段椎间盘退变分级指数分析对于评估腰椎间盘突出症术后疗效具有重要参考价值。

Objective:To investigate the effect of the degree of degeneration of intervertebral disc in adjacent segments on the surgical treatment effect of protrusion of lumbar intervertebral disc.Methods:76 patients with protrusion of lumbar intervertebral disc were treated with Pfirrmann classification of adjacent segments of intervertebral disc degeneration,the visual analogue scale(VAS),the Oswestry dysfunction index(ODI)and the effect of improved Macnab were compared before and after the treatment of different grades of patients with low back pain and lower extremity pain.Results:With the increase of Pfirrmann grade,the VAS score and ODI index of the waist and back increased significantly at 12 month after treatment(P<0.05).At 12 months after treatment,the lower lumbar VAS score in grade IV patients was significantly higher than that of the other 3 groups(P<0.05).The effective rate of patients with grade Ⅲ and grade Ⅳ was significantly lower than that of grade Ⅰ and grade Ⅱ(P<0.05).Conclusion:The analysis of intervertebral disc degeneration and grading index in the adjacent segment before operation is of important reference value in evaluating the postoperative effect of lumbar disc herniation.