Yamashita Kazuo, Aono Hiroyuki, Yamasaki Ryoji
Department of Orthopedic Surgery, Nishinomiya Municipal Central Hospital, Nishinomiya, Japan.
Spine (Phila Pa 1976). 2007 Apr 20;32(9):980-5. doi: 10.1097/01.brs.0000261031.10091.f5.
Prospective follow-up and retrospective review of 174 patients surgically treated for degenerative lumbar spinal stenosis.
To examine whether the type of leg pain syndrome associated with lumbar spinal stenosis is correlated with outcome.
Although classifying patients based on their leg pain syndrome is useful in planning surgical decompression, there is no validated method of classification and its prognostic significance remains unknown.
Based on the type of leg pain, the patients were classified into 2 groups: unilateral and bilateral. Improvement in functional status was evaluated using the Quebec Back Pain Disability Scale; the symptoms were rated on a visual analog scale and the change from baseline to 2-year evaluation was noted. Associations between score changes and baseline variables were examined using multivariate analysis.
The type of leg pain was independently associated with improvements in function and leg symptom scores but was not associated with improvement in the back pain score. After surgery, patients with unilateral leg pain had significantly greater improvements in function and leg symptoms than patients with bilateral leg pain.
In patients undergoing surgery for degenerative lumbar spinal stenosis, the preoperative type of leg pain predicts function and leg symptom outcomes.
对174例因退行性腰椎管狭窄症接受手术治疗的患者进行前瞻性随访和回顾性分析。
探讨与腰椎管狭窄症相关的腿痛综合征类型是否与手术结果相关。
尽管根据腿痛综合征对患者进行分类有助于规划手术减压，但尚无经过验证的分类方法，其预后意义也尚不清楚。
根据腿痛类型，将患者分为两组：单侧组和双侧组。使用魁北克腰痛残疾量表评估功能状态的改善情况；症状采用视觉模拟量表评分，并记录从基线到2年评估的变化。采用多变量分析检查评分变化与基线变量之间的关联。
腿痛类型与功能和腿部症状评分的改善独立相关，但与背痛评分的改善无关。术后，单侧腿痛患者在功能和腿部症状方面的改善明显大于双侧腿痛患者。
在因退行性腰椎管狭窄症接受手术的患者中，术前腿痛类型可预测功能和腿部症状的手术结果。
