腰椎间盘的手术治疗后的结果的预测因素
Gregory I Sacks1, Vincent Destefano1, Susan M Fiore2
1Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
International journal of spine surgery
|September 20, 2024
概括
手术前的物理治疗和先前的融合手术与腰椎间盘 (LDH) 患者进行微分隔切除术的结果更差有关. 较高的疼痛分数也与LDH的手术结果较差相关.
科学领域:
- 神经外科 神经外科
- 整形外科 整形外科 整形外科
- 疼痛管理 疼痛管理
背景情况:
- 腰椎间盘 (LDH) 导致根部疼痛,在美国每年进行超过30万次微椎间盘切除术.
- 显著的一小部分 (25-33%) 患者经历了LDH微分切除术后不良的外科结果.
- 识别导致手术结果不足的因素对于改善患者护理至关重要.
研究的目的:
- 为了回顾性地分析那些接受了LDH微切除术的患者.
- 为了确定与不良外科手术结果相关的人口统计,历史和外科手术因素.
- 了解LDH手术后不充分结果的预测因素.
主要方法:
- 对123名经过微切除术的LDH患者 (2017-2022) 的回顾性分析.
- 收集的数据包括人口统计,病史/外科病史和手术细节.
- 通过数值评分系统 (NRS) 疼痛或症状分辨率减少3.5个点来定义良好的结果.
主要成果:
- 之前的融合手术 (100%) 和手术前物理治疗 (PT) (73.2%) 与未能达到结果值有关.
- 接受PT治疗的患者经历了残留的根部疼痛 (79.1%) 和神经症状 (82.8%).
- 较高的手术前NRS得分与较差的结果相关 (OR=1.554).
结论:
- 较高的手术前疼痛分数,先前的融合手术和手术前的PT与LDH微分切除术后的较差结果有关.
- 在LDH手术之前,手术前的PT可能会产生有害影响.
- 需要进一步研究PT对高度LDH患者的影响.
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