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腰椎疾病术后腰痛的危险因素

Risk Factors of Postoperative Low Back Pain for Lumbar Spine Disease.

作者信息

Gu Jiaao, Guan Fulin, Zhu Lin, Guan Guofa, Chi Zhiyong, Wang Haojun, Yu Zhange

机构信息

1st Affiliated Hospital, Harbin Medical University, Harbin, Heilongjaing Province, China.

Department of Epidemiology, Harbin Medical University, Harbin, Heilongjaing Province, China.

出版信息

World Neurosurg. 2016 Oct;94:248-254. doi: 10.1016/j.wneu.2016.07.010. Epub 2016 Jul 14.

DOI:10.1016/j.wneu.2016.07.010
PMID:27423201
Abstract

PURPOSE

A retrospective study was conducted to clarify the risk factors of postoperative low back pain (LBP) for lumbar spine disease.

PATIENTS AND METHODS

A total of 401 patients who underwent lumbar operation between January 2011 and December 2011 were included in this analysis. We investigated patient characteristics and surgical approaches and also compared the radiographic characteristics.

RESULTS

The mean visual analogue scale (VAS) score decreased dramatically after the operation. The mean preoperative VAS score was greater in patients underwent posterior lumbar interbody fusion (PLIF) with longer duration of symptoms, longer operation time, and severe lumbar multifidus (LM) intramuscular adipose tissue (IMAT). The preoperative VAS score was dramatically lower in patients with lumbar herniation. The postoperative VAS score was dramatically lower in patients who underwent PLIF with longer operation time and mild LM IMAT. Postoperative LBP disappeared more often in patients who underwent PLIF with longer operation times. The number of operative levels and type of lumbar spine disease also were associated with postoperative LBP.

CONCLUSION

Type of surgery, operation time, number of operative level, and type of disease were risk factors for the postoperative LBP. Patients underwent PLIF with shorter symptom duration, longer operation time severe LM IMAT, and lumber spondylolisthesis reported more severe LBP before the operation. Patients underwent discectomy with shorter operation times.

摘要

目的

进行一项回顾性研究以阐明腰椎疾病术后下腰痛(LBP)的危险因素。

患者与方法

本分析纳入了2011年1月至2011年12月期间接受腰椎手术的401例患者。我们调查了患者特征和手术方式,并比较了影像学特征。

结果

术后视觉模拟量表(VAS)平均评分显著下降。症状持续时间较长、手术时间较长且腰椎多裂肌(LM)肌内脂肪组织(IMAT)严重的患者,术前VAS平均评分更高。腰椎间盘突出症患者术前VAS评分显著更低。手术时间较长且LM IMAT较轻的PLIF患者术后VAS评分显著更低。手术时间较长的PLIF患者术后LBP消失的情况更常见。手术节段数量和腰椎疾病类型也与术后LBP相关。

结论

手术方式、手术时间、手术节段数量和疾病类型是术后LBP的危险因素。症状持续时间较短、手术时间较长、LM IMAT严重且腰椎滑脱的PLIF患者术前LBP更严重。手术时间较短的患者接受了椎间盘切除术。

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