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对腰椎间盘的自发回归预测因素的系统审查和元分析

Sami Rashed¹, Anna Vassiliou², Joachim Starup-Hansen¹

¹1Neurosurgery Department, Charing Cross Hospital, Imperial NHS Trust, London; and.

Journal of neurosurgery. Spine

|July 24, 2023

概括

腰椎间盘 (LDH) 的自发回归在挤出或隔离的盘形态方面更有可能发生. 较大的体积和经也预测回归,有助于治疗决策.

科学领域:

脊柱医学是指脊柱医学.
放射学放射学是一门学科.
整形外科手术整形外科手术

背景情况:

腰椎间盘 (LDH) 是一种具有自发回归的常见疾病,但预测因素仍然不明.
缺乏预测因素阻碍了护理的优化,将需要早期手术的患者与适合保守管理的患者区分开来.
这项研究旨在综合现有的关于自发LDH回归预测因子的文献,以告知临床决策.

研究的目的:

系统地审查和综合现有关于自发腰椎间盘的预测因素的文献.
对已识别的预测因素进行元分析,包括磁盘形态和椎间板的特征.
建议未来的研究方向,以改善LDH管理中的临床决策.

主要方法:

在Cochrane,Embase和MEDLINE数据库中对相关研究进行全面的文献搜索.
包括使用非手术症状的LDH队列和至少两次MRI回归评估的研究.
排除了同时患有脊髓疾病的病例;与以前的评论进行综合,并对更广泛的文献进行定性分析.

主要成果:

分析了16篇文章,涉及360例LDH病例,主要是年轻男性,L4-L5或L5-S1水平的根性病变.
自发回归概率:凸出 (13.3%),突出 (52.5%),挤出 (70.4%) 和隔离 (93.0%) 的磁盘.
显著的回归预测因素包括更大的体积,横带和更高的Komori类型;症状改善与盘回归相关.

结论:

磁盘形态是自发腰椎间盘的显著预测因素.
本元分析确定了影响回归的关键因素,包括的体积和类型.
建议对早期 (<6个月) LDH回归预测因子进行进一步研究,以完善临床策略.

关键词:

腰椎椎间盘的发生预测磁盘回归的时间.这是一种坐骨神经炎.自发回归自发回归自发回归

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