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术前坐骨神经痛的持续时间会影响腰椎间盘突出症患者的手术效果吗?

Does duration of preoperative sciatica impact surgical outcomes in patients with lumbar disc herniation?

作者信息

Omidi-Kashani Farzad, Ghayem Hasankhani Ebrahim, Kachooei Amir Reza, Rahimi Mohammad Dawood, Khanzadeh Reza

机构信息

Orthopedic Research Center, Orthopedic Department, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad 913791-3316, Iran.

Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad 913791-3316, Iran.

出版信息

Neurol Res Int. 2014;2014:565189. doi: 10.1155/2014/565189. Epub 2014 Jan 28.

Abstract

Background. In lumbar disc herniation, most authors recommend nonoperative treatment for the first few weeks of presentation, but what about the upper limit of this golden period? The aim of this study is to assess the effect of preoperative sciatica duration on surgical outcome of lumbar disc herniation. Methods. We retrospectively evaluated 240 patients (124 males and 116 females) with a mean age of 36.4 ± 5.9 years (range 16 to 63) surgically treated due to primary stable L4-L5 disc herniation. The patients were placed into two groups: with more and less than 12-month duration of preoperative sciatalgia. Disability and pain were measured by Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS). Wilcoxon test and Mann-Whitney U test were used for statistical analysis. Results. Total mean duration of preoperative sciatalgia and follow-up period were 13.3 months (range 2 to 65) and 33.7 ± 5.1 months (range 24 to 72), respectively. Comparison between the groups showed that duration of preoperative sciatalgia either less or more than 12 months did not affect the surgical outcomes significantly. Conclusions. More or less than 12-month duration of preoperative sciatalgia may not affect the surgical outcomes of simple lumbar disc herniation in the patients undergoing discectomy.

摘要

背景。在腰椎间盘突出症中,大多数作者建议在发病的最初几周进行非手术治疗,但这个黄金时期的上限是多少呢?本研究的目的是评估术前坐骨神经痛持续时间对腰椎间盘突出症手术效果的影响。方法。我们回顾性评估了因原发性稳定型L4-L5椎间盘突出症接受手术治疗的240例患者(男性124例,女性116例),平均年龄36.4±5.9岁(范围16至63岁)。患者被分为两组:术前坐骨神经痛持续时间超过和少于12个月。通过Oswestry功能障碍指数(ODI)和视觉模拟量表(VAS)测量功能障碍和疼痛程度。采用Wilcoxon检验和Mann-Whitney U检验进行统计分析。结果。术前坐骨神经痛的总平均持续时间和随访期分别为13.3个月(范围2至65个月)和33.7±5.1个月(范围24至72个月)。两组之间的比较表明,术前坐骨神经痛持续时间少于或超过12个月对手术效果均无显著影响。结论。术前坐骨神经痛持续时间超过或少于12个月可能不会影响接受椎间盘切除术患者单纯腰椎间盘突出症的手术效果。

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Diagnosis and treatment of sciatica.坐骨神经痛的诊断与治疗
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