老年腰椎间盘突出症患者术前MRI特征与PELD术后疗效的相关性

doi:10.3969/j.issn.1004-7115.2021.03.004

betway必威登陆网址（betway.com ）学报 ›› 2021, Vol. 42 ›› Issue (3): 176-180.DOI: 10.3969/j.issn.1004-7115.2021.03.004

老年腰椎间盘突出症患者术前MRI特征与PELD术后疗效的相关性

谷千江

洛阳市中医院骨伤科一病区,河南洛阳 471000

收稿日期:2020-11-10 出版日期:2021-03-25 发布日期:2021-09-01
作者简介:谷千江,本科,副主任医师,主要从事骨伤科临床诊治工作,E-mail:guqj1970@163.com。

Preoperative MRI features of elderly patients with lumbar intervertebral disc herniation and their correlation with the efficacy of PELD

Gu Qian-jiang

Dept. of Orthopedics and Traumatology, Luoyang Hospital of Traditional Chinese Medicine, Luoyang 471000, China

Received:2020-11-10 Online:2021-03-25 Published:2021-09-01

摘要/Abstract

摘要： 目的观察经皮椎间孔镜下髓核摘除手术(percutaneous endoscopic lumbar discectomy,PELD)治疗老年腰椎间盘突出症(lumbar disc herniation,LDH)的临床疗效,并分析患者术前MRI特征与手术疗效的相关性。方法自2017年3月—2018年5月行PELD手术治疗41例老年LDH患者,测量其术前MRI的黄韧带厚度、椎间盘突出比值、侧隐窝大小、椎间孔前后径和上下径、椎间隙高度等数值;术后随访1年以上,评价其术后疼痛VAS评分和功能障碍ODI指数的改善情况。采用Spearman相关性分析,探讨上述MRI特征与手术疗效的相关性。结果所有患者手术后1年的平均VAS评分和ODI指数均较术前显著降低,差异有统计学意义(P<0.05)。Spearman相关性分析显示,黄韧带厚度和椎间盘突出比值与PELD术后1年的VAS评分和ODI指数均无明显相关性(|r|<0.3,P>0.05);而术前侧隐窝大小、椎间孔前后径和上下径、椎间隙高度,均与VAS评分和ODI指数呈负相关关系(均为|r|>0.3,P<0.05)。结论 PELD手术治疗老年LDH患者可取得良好疗效,其术前MRI的侧隐窝、椎间孔前后径和上下径、椎间隙高度越大,则手术疗效越好。

关键词: 腰椎间盘突出症, PELD手术, MRI特征, 老年患者, 相关性分析

Abstract: Objective: To observe the clinical efficacy of percutaneous endoscopic lumbar discectomy (PELD) in the treatment of lumbar disc herniation (LDH) in the elderly, and to analyze the correlation between preoperative MRI features and surgical outcomes. Methods: Forty-one elderly LDH patients were treated with PELD from March 2017 to May 2018. The thickness of ligamentum flavum, ratio of disc herniation, size of lateral recess, anterior and posterior diameters of intervertebral foramen, upper and lower diameters of intervertebral foramen and height of intervertebral space were measured before and after operation. The VAS score of pain and ODI index of dysfunction were evaluated after 1 year follow-up. Improvement. Spearman correlation analysis was used to investigate the correlation between the above-mentioned MRI features and surgical outcomes. Results: The average VAS score and ODI index of all patients one year after operation were significantly lower than those before operation (P< 0.05); Spearman correlation analysis showed that there was no significant correlation between the thickness of ligamentum flavum and the ratio of lumbar disc herniation and the VAS score and ODI index one year after PELD operation (|r|<0.3,P>0.05). Size of lateral recess, anterior and posterior diameter of intervertebral foramen, upper and lower diameter and height of intervertebral space were negatively correlated with VAS score and ODI index (all |r|>0.3,P<0.05). Conclusion: PELD can achieve good results in the treatment of elderly LDH patients. The bigger the lateral recess was, anterior and posterior diameter of intervertebral foramen, upper and lower diameter of intervertebral foramen and height of intervertebral space before operation are, the better the effect of PELD is .

Key words: lumbar intervertebral disc herniation, PELD surgery, MRI features, elderly patients, correlation analysis

中图分类号:

R686

谷千江. 老年腰椎间盘突出症患者术前MRI特征与PELD术后疗效的相关性[J]. betway必威登陆网址（betway.com ）学报, 2021, 42(3): 176-180.

Gu Qian-jiang. Preoperative MRI features of elderly patients with lumbar intervertebral disc herniation and their correlation with the efficacy of PELD[J]. Journal of Shandong First Medical Unversity & Shandong Academy of Medical Sciences, 2021, 42(3): 176-180.

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老年腰椎间盘突出症患者术前MRI特征与PELD术后疗效的相关性

Preoperative MRI features of elderly patients with lumbar intervertebral disc herniation and their correlation with the efficacy of PELD

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