不同年龄段腰椎间盘突出症患者非手术治疗疗效的回顾性分析

Retrospective analysis of curative effect of non-surgical treatment in patients with lumbar disc herniation at different ages

目的分析研究不同年龄段腰椎间盘突出症(lumbar disc herniation,LDH)患者非手术治疗的疗效。方法回顾选取LDH患者467例,收集患者一般资料和治疗前后视觉模拟评分(visual analogue scale,VAS)、胸腰椎活动度(range of motion,ROM)以及日本骨科协会腰痛功能障碍评分(Japanese orthopaedic association,JOA)等观察资料,观察资料采用治疗前后的差值(治疗后-治疗前)表示改善程度。按年龄将研究对象分为青年组(y<40周岁),中年组(40周岁≤y≤60周岁)以及老年组(y>60周岁)三组。结果三组患者治疗后的VAS评分、胸腰椎活动度以及JOA评分均较入院时有明显改善(P<0.05),胸腰椎前屈活动度的改善程度三组有明显差异(P<0.05),且青年组优于中年组及老年组(P<0.05);三组患者治疗后VAS评分和后伸、左右侧屈、左右旋转的胸腰椎活动度以及JOA评分的改善程度差异不具有统计学意义(P>0.05)。结论不同年龄段LDH患者均能从非手术治疗中获益,前屈活动度的改善与年龄呈负相关;但在疼痛、后伸、左右侧屈和左右旋转的胸腰椎活动度以及功能障碍的改善程度来看,各年龄段均可从非手术治疗中获益,不会因为年龄因素影响LDH患者非手术治疗的疗效。

Objective To analyze the curative effect of non-surgical treatment of lumbar disc herniation(LDH)in different age groups.Methods A total of 467 patients with LDH were retrospectively selected,the patients’general data and observation data such as Risual Analogue Scale(VAS),Range of Motion(ROM)and Japanese Orthopaedic Association Scores(JOA)before and after treatment were collected.The observation data used the difference before and after treatment(after treatment-before treatment)to indicate the degree of improvement.According to age,the subjects were divided into three groups:youth group(y<40 years old),middle-aged group(40 years old≤y≤60 years old)and elderly group(y>60 years old).Results There were significant differences in VAS score,thoracolumbar mobility and JOA score among the three groups compared with admission(P<0.05).There was significant difference in the improvement of flexion range of thoracolumbar spine among the three groups(P<0.05),and the youth group was better than the middle-aged group and the elderly group after comparison(P<0.05).There was no significant difference in the improvement of VAS score,extension,left and right lateral flexion,left and right rotation of thoracolumbar motion and JOA score among the three groups before and after treatment(P>0.05).Conclusion LDH patients in different age groups can benefit from non-surgical treatment,and the improvement of flexion activity is negatively correlated with age.However,in terms of pain,extension,left and right lateral flexion,left and right rotation of thoracolumbar mobility and improvement of dysfunction,all age groups can benefit from non-surgical treatment,and the curative effect of non-surgical treatment for LDH patients may not be affected by age factors.