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腰椎间盘突出症合并马尾神经综合征患者的人口统计学特征、术前保守治疗及手术时机与术后结果的相关性:这些因素真的重要吗?

A correlation of demographic characteristics, preoperative conservative therapy and timing with postoperative outcome in herniated disc-associated cauda equina syndrome: Do they really matter?

作者信息

Bečulić Hakija, Begagić Emir, Skomorac Rasim, Jusić Aldin, Efendić Alma, Selimović Edin, Mašović Anes, Bečulić Lejla

机构信息

Department of Neurosurgery, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina.

Department of Anatomy, School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina.

出版信息

Med Glas (Zenica). 2023 Aug 1;20(2):269-275. doi: 10.17392/1630-23.

Abstract

Aim To examine a correlation of demographic characteristics of patients, preoperative modality of conservative therapy and timing on the postoperative outcome of patients six months after the operation. Methods A retrospective, non-randomized, clinical study involved 48 patients of different age and gender with a verified diagnosis of cauda equina syndrome (CES). The inclusion criteria were patients with CES caused by discus hernia. Observed research variables were age, gender, affected vertebral level, conservative modalities of perioperative therapy (nonsteroidal anti-inflammatory drugs - NSAIDs and physiotherapy), duration of symptoms, and outcome parameters (motor and sensory function, sphincter function of the urinary bladder and bowel). Results A statistically significant negative correlation was found between age and postoperative outcome (p<0.05). The affected vertebral level was positively correlated with the motor and sensory outcome (p<0.05). A positive correlation between the use of NSAIDs and the outcome was found (R=0.570; p<0.001), as well as a negative correlation with perioperative physiotherapy (R=-0.201; p= 0.001). Postponement of surgery was negatively correlated with outcome variables (p<0.001). Conclusion The results of the study bring new conclusions that were not previously observed. Possible new characteristics associated with the outcome of cauda equina syndrome were determined.

摘要

目的 研究患者的人口统计学特征、术前保守治疗方式及时间与术后六个月患者预后的相关性。方法 一项回顾性、非随机临床研究纳入了48例年龄和性别各异且确诊为马尾神经综合征(CES)的患者。纳入标准为因椎间盘疝导致CES的患者。观察的研究变量包括年龄、性别、受累椎体节段、围手术期保守治疗方式(非甾体抗炎药 - NSAIDs和物理治疗)、症状持续时间以及预后参数(运动和感觉功能、膀胱和肠道括约肌功能)。结果 年龄与术后预后之间存在统计学显著的负相关性(p<0.05)。受累椎体节段与运动和感觉预后呈正相关(p<0.05)。发现使用NSAIDs与预后呈正相关(R=0.570;p<0.001),与围手术期物理治疗呈负相关(R=-0.201;p=0.001)。手术延迟与预后变量呈负相关(p<0.001)。结论 该研究结果带来了此前未观察到的新结论。确定了与马尾神经综合征预后相关的可能新特征。

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