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症状性腰椎退行性椎间盘疾病患者的生活质量和临床症状的治疗结果:哪种治疗方式更优?

Treatment outcome of quality of life and clinical symptoms in patients with symptomatic lumbar degenerative disc diseases: which treatment modality is superior?

机构信息

Orthopaedic and Trauma Unit, Department of Surgery, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria.

Orthopaedics and Trauma Department, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.

出版信息

Int Orthop. 2019 Apr;43(4):875-881. doi: 10.1007/s00264-018-4248-5. Epub 2018 Nov 28.

Abstract

OBJECTIVE

This was to assess the quality of life and clinical symptoms before and after treatment of patients with symptomatic lumbar degenerative disc disease (LDDD). It was also to determine the superior treatment for well-selected patients: conservative versus surgical treatment.

STUDY DESIGN

Prospective interventional analytical study.

METHODS

We studied 160 adult symptomatic patients aged 31-60 years with diagnosis of LDDD who were enrolled between May 2016 and November 2017. Their pre- and post-treatment clinical symptoms and signs and quality of life were studied using the Oswestry disability index (ODI). The data was analysed using SPSS version 24.

RESULTS

One hundred fifty-three adult patients aged 31 to 60 years completed the study. The male-to-female ratio was 1:1.5 while the symptom duration ranged between one and 14 years. The treatment modalities were medical (46%), epidural steroid injection (26%) and operative treatment (28%). The responses to the treatment were worsened symptoms (10.5%), no improvement (13.1%), moderate/slight improvement (27.5%) and significant improvement (49%). There were statistically significant improvements (p value < 0.05) in clinical symptoms, sign and ODI at six months after treatment. Surgical treatment was superior to all other form of care.

CONCLUSION

This study showed significant improvement in outcome among the participants in different treatment modalities with surgical treatment being the superior. We recommend surgical treatment for well-selected adult patients with symptomatic LDDD and assessment of quality of life and clinical symptoms before and after treatment.

摘要

目的

评估有症状的腰椎退行性疾病(LDDD)患者治疗前后的生活质量和临床症状,确定为精选患者提供的更好治疗方法:保守治疗与手术治疗。

研究设计

前瞻性干预分析研究。

方法

我们研究了 160 名年龄在 31-60 岁之间、患有 LDDD 诊断的成年有症状患者,他们于 2016 年 5 月至 2017 年 11 月期间被纳入研究。使用 Oswestry 残疾指数(ODI)评估他们治疗前后的临床症状和体征以及生活质量。使用 SPSS 版本 24 分析数据。

结果

153 名年龄在 31 至 60 岁之间的成年患者完成了这项研究。男女比例为 1:1.5,症状持续时间在 1 至 14 年之间。治疗方式为药物治疗(46%)、硬膜外类固醇注射(26%)和手术治疗(28%)。治疗后的反应是症状恶化(10.5%)、无改善(13.1%)、中度/轻度改善(27.5%)和显著改善(49%)。治疗后 6 个月,临床症状、体征和 ODI 均有统计学意义上的改善(p 值<0.05)。手术治疗明显优于其他治疗方式。

结论

这项研究表明,不同治疗方式的参与者的结果都有显著改善,手术治疗是更好的选择。我们建议对有症状的 LDDD 成年患者进行手术治疗,并在治疗前后评估生活质量和临床症状。

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