神经根沉降征在非手术治疗腰椎间盘突出症中的疗效预测价值

Predictive value of nerve root sedimentation sign in non-surgical treatment of lumbar disc herniation

目的 评估神经根沉降征评估腰椎间盘突出症经非手术治疗后疗效的预测价值。方法 回顾性分析自2020-01—2021-05采用非手术治疗的75例腰椎间盘突出症,44例神经根沉降征阳性(阳性组),31例神经根沉降征阴性(阴性组)。比较两组硬膜囊受压面积比、腰椎间盘突出症类型,比较两组治疗前、治疗后1周、治疗后1个月腰痛VAS评分、下肢痛VAS评分、JOA评分、ODI指数,比较两组末次随访时疗效显效率。结果 两组均顺利完成非手术治疗。阳性组硬膜囊受压面积比、中央型腰椎间盘突出症占比较阴性组高,差异有统计学意义(P<0.05)。治疗后1周阳性组下肢疼痛VAS评分较阴性组高,差异有统计学意义(P<0.05);治疗后1个月阳性组腰痛VAS评分、下肢痛VAS评分、ODI指数较阴性组高,JOA评分较阴性组低,差异有统计学意义(P<0.05)。末次随访时,阳性组临床疗效显效率较阴性组低,差异有统计学意义(P<0.05)。结论 腰椎间盘突出症神经根沉降征阴性患者经非手术治疗后临床疗效优于神经根沉降征阳性患者。神经根沉降征作为一种与腰椎间盘突出症密切相关的影像学征象,可能是评估腰椎间盘突出症经非手术治疗后临床疗效差异的重要参考指标。

ObjectiveTo evaluate the value of nerve root sedimentation sign in predicting clinical outcomes of the non-surgical treatment of patients with lumbar disc herniation.MethodsFrom January 2020 to May 2021, 75 patients with lumbar disc herniation who accepted non-surgical treatment were retrospectively analyzed, including 44 patients with positive nerve root sedimentation sign(positive group) and 31 patients with negative nerve root sedimentation sign(negative group). The ratio of dural sac compression area and the type of lumbar disc herniation in the two groups were analyzed, and the low back pain VAS score, lower limb pain VAS score, JOA score, and ODI were compared between groups before treatment, 1 week, and 1 month after treatment. The curative effects of the two groups were compared at the last follow-up.ResultsBoth groups of patients were completed non-surgical treatment successfully. The ratio of dural sac compression area and the proportion of central lumbar intervertebral disc herniation in the positive group were higher than those in the negative group, and the differences were statistically significant(P<0.05). One week after treatment, the VAS score of lower extremity pain in the positive group was higher than that in the negative group, and the difference was statistically significant(P<0.05). One month after treatment, low back pain VAS score, lower limb pain VAS score, and ODI index in the positive group were higher than those in the negative group, and the JOA score was lower than that in the negative group, and the difference was statistically significant(P<0.05). At the last follow-up, the clinical curative effect rate of the positive group was lower than that of the negative group, and the difference was statistically significant(P<0.05).ConclusionThe clinical efficacy of lumbar disc herniation patients with negative nerve root sedimentation sign after non-surgical treatment is better than that of patients with positive nerve root sedimentation sign. As an imaging sign closely related to lumbar disc herniation, nerve root sedimentation sign may be important to evaluate the clinical efficacy of patients with lumbar disc herniation undergoing non-surgical treatment.