退行性腰椎滑脱症患者下肢放射痛相关因素分析

Analysis of related factors of radiating pain of lower limb in patients with degenerative lumbar spondylolisthesis

目的探讨影响退行性腰椎滑脱症患者下肢放射痛的相关因素。方法回顾性分析自2017-07—2018-07诊治的108例退行性腰椎滑脱症,78例术前存在下肢放射痛(疼痛组),30例术前无下肢放射痛(无疼痛组)。探讨年龄、椎间隙相对高度、肌力下降、下肢感觉异常与退行性腰椎滑脱症患者出现下肢放射痛的相关性。结果研究结果显示,疼痛组术前椎间隙相对高度为(0.26±0.01)mm,无疼痛组为(0.33±0.01)mm;疼痛组术前椎间隙相对高度较无疼痛组低,差异有统计学意义(P <0.05)。年龄、肌力下降、下肢感觉异常与退行性腰椎滑脱症患者下肢放射痛存在相关性,年龄≥65岁者发生下肢放射痛的概率是年龄<65岁者的3.38倍,肌力下降患者发生下肢放射痛的概率是肌力正常患者的3.00倍,下肢感觉异常患者发生下肢放射痛的概率是下肢感觉正常患者的5.57倍。结论高龄、肌力下降、下肢感觉异常、椎间隙相对高度下降是退行性腰椎滑脱症患者出现下肢放射痛的危险因素。

Objective To explore the related factors of radiating pain of lower limb in patients with degenerative lumbar spondylolisthesis.Methods From July 2017 to July 2018,clinical data of 108 patients with degenerative lumbar spondylolisthesis were collected.Among them,78 patients had radiating pain of lower limb before treatment(pain group),30 patients had no radiating pain of lower limb before treatment(pain free group).A retrospective analysis was conducted to explore the correlation between age,declining of muscle strength,paresthesia of lower limbs,relative intervertebral space height and radiating pain of lower limb in degenerative lumbar spondylolisthesis.Results The results showed that the relative height of the preoperative intervertebral space in the pain group was(0.26±0.01)mm,that in the pain free group was(0.33±0.01)mm,and that the relative height of the vertebral space in the pain group before treatment was lower than that in the pain free group,with a statistically significant difference(P<0.05).Age,declining of muscle strength,paresthesia of lower limbs were correlated with radiating pain of lower limb in patients with degenerative lumbar spondylolisthesis.The incidence of radiating pain of lower limb in patients with age≥65 was 3.38 times of that in patients with age<65.The incidence of radiating pain of lower limb in patients with declining of muscle strength was 3.00 times of that in patients with normal muscle strength.The incidence of radiating pain of lower limb in patients with paresthesia of lower limbs was 5.57 times of that in patients without paresthesia of lower limbs.Conclusion Advanced age,declining of muscle strength,paresthesia of lower limbs and reduction of relative height of intervertebral space are the risk factors of radiating pain of lower limb in patients with degenerative lumbar spondylolisthesis.