在不同年龄组的腰椎间盘椎间盘的组织构成和临床症状之间的关联
Kenichi Kawaguchi1, Hirokazu Saiwai1, Kazu Kobayakawa1
1Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Spine
|October 25, 2024
概括
椎间盘的软骨末端板 (CEs) 根据年龄不同影响结果. 患有CE的年轻患者可能会出现运动软弱,而老年患者在手术后可能会持续下腰痛.
科学领域:
- 神经外科 神经外科
- 整形外科 整形外科 整形外科
- 脊柱外科手术 脊柱外科手术
背景情况:
- 腰椎间盘 (LDH) 涉及软骨末端板 (CEs) 随着年龄的增长而变得更为常见.
- CEs更硬,吸收能力较差,可能会改变LDH的进展和手术结果.
- 了解CE参与对于管理LDH至关重要,尤其是在不同年龄的人群中.
研究的目的:
- 调查椎间板的软骨末端板 (CE) 对临床症状和术后结果的影响.
- 为了在不同年龄组 (<50岁和≥50岁) 的腰椎间盘 (LDH) 患者中比较CE的影响.
- 检查LDH患者中CE特征和临床症状之间的关联.
主要方法:
- 对从239名接受显微盘切除术的患者前性收集的数据进行了回顾性分析.
- 通过运动强度,疼痛视觉模拟尺度 (VAS) 和罗兰-莫里斯残疾问卷来评估结果.
- 对临床变量和年龄组之间的结果 (<50 vs. ≥50岁) 的CE影响的比较,包括CE占用率.
主要成果:
- 软骨末端板 (CEs) 在老年患者和那些有Modic变化的患者中更为普遍.
- 在年轻患者 (<50岁) 中,较高的CE占用率 (≥20%) 与手术前运动弱相关.
- 患有CE的老年患者 (≥50岁) 报告了术后腰部疼痛 (LBP) 的增加,并在1年后显示了CE和残留LBP之间的独立关联.
结论:
- 在年轻患者中,具有较高CE占用率的突破型可能会导致手术前的运动软弱.
- 虽然切除术改善了不论CE的结果,但老年患者的软骨带可能会导致术后持续的腰部疼痛.
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