改良椎间孔镜技术治疗腰椎间盘突出症的疗效及预后影响因素分析

Curative effect and prognostic factors of improved intervertebral foramina technology intreatment of lumbar disc herniation

目的探讨在腰椎间盘突出症治疗中实施改良椎间孔镜技术的疗效及影响治疗效果的危险因素。方法选取2017年4月至2018年4月本院收治的行改良椎间孔镜技术治疗的80例腰椎间盘突出症患者,并对其进行回顾性分析。对患者进行为期6~15个月的随访,比较两组患者术前及随访期间的VAS和JOA评分,将其作为疗效评价指标,并且对影响治疗效果的高危因素进行分析。结果80例患者完成手术治疗,其中疗效评定为优的51.25%(41/80)、良21.25%(17/80)、中16.25%(13/80)、差11.25%(9/80),总有效率为88.75%(71/80);单因素分析显示:年龄、患病时长、Pfirrmann分级、手术节段及临床表现等因素会影响治疗效果;多因素分析显示:年龄45岁以上、病程周期长于12个月、合并腰脚痛、Pfirrmann分级为Ⅵ级是影响疗效的独立危险因素。结论改良椎间孔镜技术应用于腰椎间盘突出症疗效明显,对患者创伤小,45岁以上、病程长于12个月、合并腰脚痛及PfirrmannⅥ级等危险因素会影响治疗效果。

Objective To explore the effect and risk factors of modified foramina technology in the treatment of lumbar disc herniation.Methods From April,2017 to April,2018,80 patients with lumbar disc herniation treated with modified intervertebral foramina technology at our hospital were retrospectively analyzed.The patients were followed up for 6-15 months.The VAS and JOA scores of the two groups were compared before and during the follow-up.The VAS and JOA scores were used as the evaluation indicators of curative effect.The high-risk factors affecting the therapeutic effect were analyzed.Results All the 80 patients completed the operation,with excellent curative effect in 41 cases(51.25%),good in 17 cases(21.25%),medium in 13 cases(16.25%),and poor in 9 cases(11.25%);and the total effective rate was 88.75%(71/80).Univariate analysis showed that age,disease duration,Pfirrmann grade,operation segment,and clinical manifestations affected the treatment effect.Multivariate analysis showed that over 45 years old,the disease course longer than 12 months,complicated with pain on spine and feet,and Pfirrmann gradeⅥwere independent risk factors affecting the efficacy.Conclusion Modified foramina technology for lumbar disc herniation is effective;and the risk factors,such as less trauma,more than 45 years old,disease course longer than 12 months,complicated with pain on spine and feet,and Pfirrmann gradeⅥaffect the treatment effect.