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经皮内镜下腰椎间盘切除术术后残留症状的预后因素

Prognostic factors for residual symptoms following percutaneous endoscopic lumbar discectomy.

作者信息

Yu Yang, Wang Jingming, Wang Lei, Xing Wenqiang, Xu Xiaoduo, Zhu Tiantian, Gong Qinglei, Huang Weimin

机构信息

Orthopedic Department, 960 Hospital of People's Liberation Army, NO.25 Shifan Road, Jinan, Shandong, 250031, People's Republic of China.

Statistics Department, 960 Hospital of People's Liberation Army, NO.25 Shifan Road, Jinan, Shandong, 250031, People's Republic of China.

出版信息

Neurosurg Rev. 2024 May 30;47(1):250. doi: 10.1007/s10143-024-02486-x.

Abstract

To explore the risk factors for residual symptoms following percutaneous endoscopic lumbar discectomy (PELD). A retrospective case-controlled study. From January 2015 to December 2020, consecutive patients who underwent PELD for lumbar disc herniation (LDH) in our department were retrospectively studied. All the patients were followed-up at least two years. Residual symptoms were analyzed for association with baseline data, clinical feature, physical examination, and radiographic characteristics, which were used to detected the risk factors. A total of 339 patients were included in this study, with a mean follow-up of 28.7 ± 3.6 months. Of the enrolled patients, 90 (26.5%) patients experienced residual low back pain (LBP), and 76 (22.4%) patients experienced leg numbness (LN). Multivariate logistic regression analysis revealed that intervertebral disc calcification on CT scans (odd ratio, 0.480; 95% confidence interval: 0.247 ~ 0.932; P < 0.05) was independent risk factor for postoperative residual LBP with odd ratio and longer symptom duration was risk factor for postoperative residual LN (odd ratio, 2.231; 95% confidence interval:1.066 ~ 4.671; P < 0.05). Residual symptoms following transforaminal endoscopic surgery are quite prevalent. Intervertebral disc calcification is a protective factor for residual low back pain, and a longer symptom duration is a risk factor for residual leg numbness.

摘要

探讨经皮内镜下腰椎间盘切除术(PELD)后残留症状的危险因素。一项回顾性病例对照研究。回顾性研究2015年1月至2020年12月在我科因腰椎间盘突出症(LDH)接受PELD的连续患者。所有患者均随访至少两年。分析残留症状与基线数据、临床特征、体格检查及影像学特征的相关性,以检测危险因素。本研究共纳入339例患者,平均随访28.7±3.6个月。在纳入的患者中,90例(26.5%)患者有残留下腰痛(LBP),76例(22.4%)患者有腿部麻木(LN)。多因素logistic回归分析显示,CT扫描显示椎间盘钙化(比值比,0.480;95%置信区间:0.247~0.932;P<0.05)是术后残留LBP的独立危险因素,而比值比和更长的症状持续时间是术后残留LN的危险因素(比值比,2.231;95%置信区间:1.066~4.671;P<0.05)。椎间孔镜手术后残留症状相当普遍。椎间盘钙化是残留下腰痛的保护因素,而更长的症状持续时间是残留腿部麻木的危险因素。

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