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减压手术后腰椎管狭窄症患者下腰痛的改善情况及预测残留下腰痛的因素

Improvement of Lower Back Pain in Lumbar Spinal Stenosis After Decompression Surgery and Factors That Predict Residual Lower Back Pain.

作者信息

Kitagawa Takahiro, Ogura Yoji, Kobayashi Yoshiomi, Takahashi Yoshiyuki, Yonezawa Yoshiro, Yoshida Kodai, Takahashi Yohei, Yasuda Akimasa, Shinozaki Yoshio, Ogawa Jun

机构信息

46626Japanese Red Cross Shizuoka Hospital, Ohtemachi, Aoi-ku, Shizuoka, Japan.

Fujita Health University, Dengakugakubo, Kutsukakecho, Toyoake, Aichi, Japan.

出版信息

Global Spine J. 2021 Mar;11(2):212-218. doi: 10.1177/2192568220905617. Epub 2020 Feb 17.

DOI:10.1177/2192568220905617
PMID:32875871
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7882817/
Abstract

STUDY DESIGN

Retrospective observational study.

OBJECTIVES

There is no consensus to predict improvement of lower back pain (LBP) in lumbar spinal stenosis after decompression surgery. The aim of this study was to evaluate the improvement of LBP and analyze the preoperative predicting factors for residual LBP.

METHODS

We retrospectively reviewed 119 patients who underwent lumbar decompression surgery without fusion and had a minimum follow-up of 1 year. LBP was evaluated using the numerical rating scale (NRS), Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) LBP score, and Roland-Morris Disability Questionnaire (RMDQ). All patients were divided into LBP improved group (group I) and LBP residual group (group R) according to the NRS score. Radiographic images were examined preoperatively and at the final follow-up. We evaluated spinopelvic radiological parameters and analyzed the differences between group I and group R.

RESULTS

LBP was significantly improved after decompression surgery (LBP NRS, 5.7 vs 2.6, < .001; JOABPEQ LBP score, 41.3 vs 79.6, < .001; RMDQ, 10.3 vs 3.6, < .001). Of 119 patients, 94 patients were allocated to group I and 25 was allocated to group R. There was significant difference in preoperative thoracolumbar kyphosis between group I and group R.

CONCLUSIONS

Most cases of LBP in lumbar spinal stenosis were improved after decompression surgery without fusion. Preoperative thoracolumbar kyphosis predicted residual LBP after decompression surgery.

摘要

研究设计

回顾性观察研究。

目的

对于腰椎管狭窄减压手术后下腰痛（LBP）改善情况的预测尚无共识。本研究旨在评估LBP的改善情况并分析术前残余LBP的预测因素。

方法

我们回顾性分析了119例行非融合腰椎减压手术且至少随访1年的患者。使用数字评分量表（NRS）、日本骨科协会腰痛评估问卷（JOABPEQ）的LBP评分以及罗兰-莫里斯功能障碍问卷（RMDQ）评估LBP。根据NRS评分将所有患者分为LBP改善组（I组）和LBP残留组（R组）。术前及末次随访时检查影像学图像。我们评估了脊柱骨盆放射学参数并分析了I组和R组之间的差异。

结果

减压手术后LBP显著改善（LBP NRS评分，5.7对2.6，P <.001；JOABPEQ LBP评分，41.3对79.6，P <.001；RMDQ评分，10.3对3.6，P <.001）。119例患者中，94例被分配至I组，25例被分配至R组。I组和R组术前胸腰椎后凸存在显著差异。

结论

大多数腰椎管狭窄症的LBP病例在非融合减压手术后得到改善。术前胸腰椎后凸可预测减压手术后的残余LBP。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004a/7882817/935f83fcc85a/10.1177_2192568220905617-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004a/7882817/b2d24e85311b/10.1177_2192568220905617-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004a/7882817/ac39a501a876/10.1177_2192568220905617-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004a/7882817/6a0a9bdf82e1/10.1177_2192568220905617-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004a/7882817/a52fa7051b5b/10.1177_2192568220905617-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004a/7882817/935f83fcc85a/10.1177_2192568220905617-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004a/7882817/b2d24e85311b/10.1177_2192568220905617-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004a/7882817/ac39a501a876/10.1177_2192568220905617-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004a/7882817/6a0a9bdf82e1/10.1177_2192568220905617-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004a/7882817/a52fa7051b5b/10.1177_2192568220905617-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/004a/7882817/935f83fcc85a/10.1177_2192568220905617-fig5.jpg

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