非手术综合康复治疗颈椎管狭窄症患者的疗效观察

Therapeutic effect of non-surgical comprehensive rehabilitation on patients with cervical spinal stenosis

目的探讨非手术综合康复治疗颈椎管狭窄症患者的疗效和可能的相关影响因素。方法收集2012年8月~2017年9月我院108例颈椎管狭窄症患者,在治疗前后分别进行JOA评分、VAS疼痛评定。1年随访患者治疗的远期疗效,并对其中复诊的32例患者复查颈椎MRI进行前后比较,分析远期疗效与相关因素间的关系。结果108例颈椎管狭窄症患者治疗后,JOA评分和VAS评分比治疗前有明显改善(P<0.01);随访结果显示非手术综合康复治疗的远期总有效率为91.7%;治疗前后颈椎MRI对比提示非手术综合康复治疗对颈椎结构退变无明显疗效。颈椎管狭窄症患者非手术治疗长期疗效与患者的年龄(r=-0.881,P=0.000)、黄韧带增厚程度(r=-0.873,P=0.000)、椎间盘突出程度(r=-0.914,P=0.000)呈负相关关系。结论非手术综合康复治疗颈椎管狭窄症具有安全、无创、简单、远期疗效满意的特点,是颈椎管狭窄症患者治疗手段中的一种优良选择。

Objective To investigate the efficacy and possible related factors of non-surgical comprehensive rehabilitation for patients with cervical spinal stenosis. Methods A total of 108 patients with cervical spinal stenosis admitted to our hospital from August 2012 to September 2017 were enrolled. The JOA score and VAS pain assessment were performed before and after treatment. Long-term efficacy was followed up after 1 year. And the cervical MRI in 32 patients who were reviewed was compered before and after the review. The relationship between long-term efficacy and related factors was analyzed. Results After treatment of 108 patients with cervical spinal stenosis, the JOA score and VAS score were significantly improved compared with those before treatment(P<0.01). The follow-up results showed that the long-term total effective rate of non-surgical comprehensive rehabilitation was 91.7%. It was suggested that non-surgical comprehensive rehabilitation therapy had no obvious effect on cervical degeneration before and after treatment. There was a negative correlation between the long-term efficacy of non-surgical treatment and the age(r=-0.881,P=0.000), the degree of ligamentum flavum thickening(r=-0.873, P=0.000), and the degree of disc herniation(r=-0.914,P=0.000) in patients with cervical spinal stenosis. Conclusions Non-surgical comprehensive rehabilitation for cervical spinal stenosis is safe, non-invasive, simple, and has long-term satisfactory results. It is an excellent choice for the treatment of cervical spinal stenosis patients.