平板运动试验对预测腰椎管狭窄症的诊断价值。
The diagnostic value of a treadmill test in predicting lumbar spinal stenosis.
作者信息
Barz Thomas, Melloh Markus, Staub Lukas, Roeder Christoph, Lange Jörn, Smiszek Franz-Georg, Theis Jean-Claude, Merk Harry R
机构信息
Spine Center, Department of Orthopaedic Surgery, University of Greifswald, Greifswald, Germany.
出版信息
Eur Spine J. 2008 May;17(5):686-90. doi: 10.1007/s00586-008-0593-1. Epub 2008 Feb 8.
Lumbar spinal stenosis is a frequent indication for spinal surgery. The predictive quality of treadmill testing and MRI for diagnostic verification is not yet clearly defined. Aim of the current study was to assess correlations between treadmill testing and MRI findings in the lumbar spine. Twenty-five patients with lumbar spinal stenosis were prospectively examined. Treadmill tests were performed and the area of the dural sac and neuroforamina was examined with MRI for the narrowest spinal segment. VAS and ODI were used for clinical assessment. The median age of the patients was 67 years. In the narrowest spinal segment the median area of the dural sac was 91 mm(2). The median ODI was 66 per cent. The median walking distance in the treadmill test was 70 m. The distance reached in the treadmill test correlated with the area of the dural sac (Spearman's rho = 0.53) and ODI (rho = -0.51), but not with the area of the neuroforamina and VAS. The distance reached in the treadmill test predicts the grade of stenosis in MRI but has a limited diagnostic importance for the level of clinical symptoms in lumbar spinal stenosis.
腰椎管狭窄症是脊柱手术的常见适应症。目前尚不清楚跑步机测试和磁共振成像（MRI）用于诊断验证的预测质量。本研究的目的是评估跑步机测试与腰椎MRI结果之间的相关性。对25例腰椎管狭窄症患者进行了前瞻性检查。进行了跑步机测试，并通过MRI检查了最狭窄脊柱节段的硬膜囊和神经孔面积。采用视觉模拟评分法（VAS）和Oswestry功能障碍指数（ODI）进行临床评估。患者的中位年龄为67岁。在最狭窄的脊柱节段，硬膜囊的中位面积为91平方毫米。ODI的中位数为66%。跑步机测试中的中位步行距离为70米。跑步机测试中达到的距离与硬膜囊面积（Spearman秩相关系数rho = 0.53）和ODI（rho = -0.51）相关，但与神经孔面积和VAS无关。跑步机测试中达到的距离可预测MRI中的狭窄程度，但对腰椎管狭窄症临床症状的严重程度诊断价值有限。
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