Objective： To identify radiographic predictors of residual low back pain （LBP） after laminectomy for lumbar canal stenosis Methods： （LCS） Clinical results and radiographic findings in 69 patients who underwent ...Objective： To identify radiographic predictors of residual low back pain （LBP） after laminectomy for lumbar canal stenosis Methods： （LCS） Clinical results and radiographic findings in 69 patients who underwent single level laminectomy for LCS were retrospectively reviewed. Patients who had an improvement in LBP scores evaluated by Japanese Orthopaedic Association （JOA） scoring system during the fol- low-up periods were classified as the recovery group, and others were classified as the non-recovery group. Patients＇ clinical data and radiographic parameters like lordosis angle, range of motion and intervertebral rotational angle were analyzed using binary logistic regression analysis to detect factors significantly related with the occurrence of residual LBP. Results： The average preoperative JOA score of 14.8± 5.05 improved to 21.59±5.51 at the final follow-up. Binary logistic regression analysis revealed that significant predictors of residual LBP were preoperative lumbar lordosis angle and range of motion. Conclusions： Our results suggest that patients with flat back and limited lumbar mobility before surgery tend to have poor results in terms of LBP. Therefore, these sagittal radiographic parameters should be taken into account when choosing laminectomy as the surgical option for LCS.展开更多
AIM To assess the correlation of lateral recess stenosis(LRS) of lumbar segments L4/5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS Nine hundred and twenty-seven patients with history of low back pain were ...AIM To assess the correlation of lateral recess stenosis(LRS) of lumbar segments L4/5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS Nine hundred and twenty-seven patients with history of low back pain were included in this uncontrolled study.On magnetic resonance images(MRI) the lateral recesses(LR) at lumbar levels L4/5 and L5/S1 were evaluated and each nerve root was classified into a 4-point grading scale(Grade 0-3) as normal,not deviated,deviated or compressed.Patient symptoms and disability were assessed using ODI.The Spearman's rank correlation coefficient was used for statistical analysis(P < 0.05).RESULTS Approximately half of the LR revealed stenosis(grade 1-3;52% at level L4/5 and 42% at level L5/S1) with 2.2% and 1.9% respectively reveal a nerve root compression.The ODI score ranged from 0%-91.11% with an arithmetic mean of 34.06% ± 16.89%.We observed a very weak statistically significant positive correlation between ODI and LRS at lumbar levels L4/5 and L5/S1,each bilaterally(L4/5 left:rho < 0.105,P < 0.01;L4/5 right:rho < 0.111,P < 0.01;L5/S1 left:rho 0.128,P < 0.01;L5/S1 right:rho < 0.157,P < 0.001).CONCLUSION Although MRI is the standard imaging tool for diagnosing lumbar spinal stenosis,this study showed only a weak correlation of LRS on MRI and clinical findings.This can be attributed to a number of reasons outlined in this study,underlining that imaging findings alone are not sufficient to establish a reliable diagnosis for patients with LRS.展开更多
目的观察三氧治疗椎管内麻醉后腰背部疼痛的疗效。方法收集我院就诊的曾行椎管内麻醉后出现腰背部疼痛患者140例,随机分为三氧治疗组及常规治疗组,每组各70例。三氧治疗组:三氧浓度为30μg/m L,每次棘突间注射5 m L,每间隔1天注射一次,...目的观察三氧治疗椎管内麻醉后腰背部疼痛的疗效。方法收集我院就诊的曾行椎管内麻醉后出现腰背部疼痛患者140例,随机分为三氧治疗组及常规治疗组,每组各70例。三氧治疗组:三氧浓度为30μg/m L,每次棘突间注射5 m L,每间隔1天注射一次,3次为一疗程。常规治疗组:选择局部封闭治疗为主,封闭治疗药物为2%利多卡因2 m L+地塞米松1mg+0.9%氯化钠注射液配成5 m L混合液,每次棘突间注射5 m L,每间隔1天注射一次,3次为一疗程。结果三氧治疗组总有效率(95.71%)高于常规治疗组(81.43%);两组在治疗后的疼痛评分、平均疼痛缓解时间、日常生活能力评分及睡眠质量评分比较,差异有显著的统计学意义(P<0.01)。结论三氧治疗椎管内麻醉后腰背部疼痛的疗效确切,值得临床推广。展开更多
文摘Objective： To identify radiographic predictors of residual low back pain （LBP） after laminectomy for lumbar canal stenosis Methods： （LCS） Clinical results and radiographic findings in 69 patients who underwent single level laminectomy for LCS were retrospectively reviewed. Patients who had an improvement in LBP scores evaluated by Japanese Orthopaedic Association （JOA） scoring system during the fol- low-up periods were classified as the recovery group, and others were classified as the non-recovery group. Patients＇ clinical data and radiographic parameters like lordosis angle, range of motion and intervertebral rotational angle were analyzed using binary logistic regression analysis to detect factors significantly related with the occurrence of residual LBP. Results： The average preoperative JOA score of 14.8± 5.05 improved to 21.59±5.51 at the final follow-up. Binary logistic regression analysis revealed that significant predictors of residual LBP were preoperative lumbar lordosis angle and range of motion. Conclusions： Our results suggest that patients with flat back and limited lumbar mobility before surgery tend to have poor results in terms of LBP. Therefore, these sagittal radiographic parameters should be taken into account when choosing laminectomy as the surgical option for LCS.
文摘AIM To assess the correlation of lateral recess stenosis(LRS) of lumbar segments L4/5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS Nine hundred and twenty-seven patients with history of low back pain were included in this uncontrolled study.On magnetic resonance images(MRI) the lateral recesses(LR) at lumbar levels L4/5 and L5/S1 were evaluated and each nerve root was classified into a 4-point grading scale(Grade 0-3) as normal,not deviated,deviated or compressed.Patient symptoms and disability were assessed using ODI.The Spearman's rank correlation coefficient was used for statistical analysis(P < 0.05).RESULTS Approximately half of the LR revealed stenosis(grade 1-3;52% at level L4/5 and 42% at level L5/S1) with 2.2% and 1.9% respectively reveal a nerve root compression.The ODI score ranged from 0%-91.11% with an arithmetic mean of 34.06% ± 16.89%.We observed a very weak statistically significant positive correlation between ODI and LRS at lumbar levels L4/5 and L5/S1,each bilaterally(L4/5 left:rho < 0.105,P < 0.01;L4/5 right:rho < 0.111,P < 0.01;L5/S1 left:rho 0.128,P < 0.01;L5/S1 right:rho < 0.157,P < 0.001).CONCLUSION Although MRI is the standard imaging tool for diagnosing lumbar spinal stenosis,this study showed only a weak correlation of LRS on MRI and clinical findings.This can be attributed to a number of reasons outlined in this study,underlining that imaging findings alone are not sufficient to establish a reliable diagnosis for patients with LRS.
文摘目的观察三氧治疗椎管内麻醉后腰背部疼痛的疗效。方法收集我院就诊的曾行椎管内麻醉后出现腰背部疼痛患者140例,随机分为三氧治疗组及常规治疗组,每组各70例。三氧治疗组:三氧浓度为30μg/m L,每次棘突间注射5 m L,每间隔1天注射一次,3次为一疗程。常规治疗组:选择局部封闭治疗为主,封闭治疗药物为2%利多卡因2 m L+地塞米松1mg+0.9%氯化钠注射液配成5 m L混合液,每次棘突间注射5 m L,每间隔1天注射一次,3次为一疗程。结果三氧治疗组总有效率(95.71%)高于常规治疗组(81.43%);两组在治疗后的疼痛评分、平均疼痛缓解时间、日常生活能力评分及睡眠质量评分比较,差异有显著的统计学意义(P<0.01)。结论三氧治疗椎管内麻醉后腰背部疼痛的疗效确切,值得临床推广。
