Anjarwalla N K, Brown L C, McGregor A H
Division of Surgery, Oncology, Reproductive Biology & Anaesthetics (SORA), Faculty of Medicine, Imperial College London, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK.
Eur Spine J. 2007 Nov;16(11):1842-7. doi: 10.1007/s00586-007-0393-z. Epub 2007 May 23.
Decompression surgery is an increasingly common operation for the treatment of lumbar spinal stenosis. Although good relief from leg pain is expected after surgery, long term results of pain relief and function are more uncertain. This study prospectively followed a cohort of patients presenting with the signs and symptoms of spinal stenosis, who underwent decompression surgery to ascertain the long term outcome with respect to pain and function using visual analogue pain scores, the Oswestry Disability Index, and the Short Form 36, a general health questionnaire. From an initial pool of 84 recruited patients, 7 withdrew from surgical intervention; of the remaining 77, 51 (66%) returned for follow up assessments at 5 years. In these responders, a significant improvement was observed in back and leg pain, which was sustained for at least 1 year (P < 0.01). A significant improvement was also seen in physical function (P < 0.05) as assessed by Oswestry and SF-36. Although an initial improvement was noted in social function, this was not observed at 5 years. This study has demonstrated that decompression surgery is successful in relieving symptoms of lumbar spinal stenosis. Physical function, back and leg pain are significantly improved after 5 years but initial significant improvements in social function diminish over time.
减压手术是治疗腰椎管狭窄症越来越常见的一种手术。虽然术后预期腿部疼痛能得到良好缓解，但疼痛缓解和功能的长期效果更不确定。本研究前瞻性地追踪了一组出现椎管狭窄体征和症状且接受减压手术的患者，使用视觉模拟疼痛评分、奥斯威斯功能障碍指数和一般健康调查问卷简短健康调查量表（SF-36）来确定疼痛和功能方面的长期结果。在最初招募的84名患者中，7名退出了手术干预；在其余77名患者中，51名（66%）在5年时返回进行随访评估。在这些有回应的患者中，观察到背部和腿部疼痛有显著改善，且至少持续了1年（P<0.01）。通过奥斯威斯和SF-36评估，身体功能也有显著改善（P<0.05）。虽然最初在社会功能方面有改善，但在5年时未观察到这种情况。这项研究表明，减压手术成功缓解了腰椎管狭窄症的症状。5年后身体功能、背部和腿部疼痛有显著改善，但社会功能最初的显著改善会随着时间而减弱。
