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人口统计学特征、肥胖、手术水平和椎间盘特性对腰椎间盘突出症复发的影响。

The Impact of Demographic Characteristics, Obesity, Surgical Level, and Intervertebral Disc Properties on Recurrence of Lumbar Disc Herniation.

机构信息

Department of Neurosurgery, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey.

Department of Neurosurgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.

出版信息

World Neurosurg. 2024 Oct;190:e748-e753. doi: 10.1016/j.wneu.2024.07.214. Epub 2024 Aug 5.

Abstract

BACKGROUND

This study focused on identifying factors influencing recurrent lumbar disc herniation (RLDH) by analyzing demographic data, body mass index (BMI), and radiologic disc properties in patients undergoing single-level unilateral lumbar disc herniation surgery.

METHODS

Our retrospective analysis included 2 groups from our clinic: Group 1 (n = 41) with patients experiencing RLDH requiring a second surgery, and Group 2 (n = 73) with patients having a single surgery and no recurrence over at least a 5-year follow-up. We assessed age, sex, diabetes mellitus (DM), hypertension (HT), BMI, Pfirrmann disc degeneration type, herniation types (protrusion, extrusion, and sequestration), and surgical level.

RESULTS

The mean ages of Groups 1 and 2 were 48.93 ± 13.47 and 44.4 ± 11.79 years, respectively, with no significant age difference (P = 0.064). Gender distribution was also not significantly different, with 63.41% males in Group 1 and 56.16% in Group 2 (P = 0.450). DM prevalence was similar in both groups (P = 0.727). Notably, HT was significantly lower in Group 2 (P = 0.018). The average BMI was comparable between groups (P = 0.607), and no significant difference in Pfirrmann disc degeneration scores was observed (P = 0.547). Radiologic disc type distributions did not significantly differ (P = 0.448). Most surgeries in both groups were at the L4-5 level, with no significant differences in surgical levels (P = 0.456).

CONCLUSIONS

We found that factors like gender, age, DM, obesity, surgical level, disc degeneration, and disc types do not significantly impact RLDH. However, the higher occurrence of HT in recurrent cases indicates a potential area for further research.

摘要

背景

本研究通过分析行单节段单侧腰椎间盘突出症手术的患者的人口统计学数据、体重指数(BMI)和影像学椎间盘特征,旨在确定影响复发性腰椎间盘突出症(RLDH)的因素。

方法

我们的回顾性分析包括来自我们诊所的 2 组患者:组 1(n=41)为需要再次手术的 RLDH 患者,组 2(n=73)为单节段单侧腰椎间盘突出症手术且至少 5 年随访无复发的患者。我们评估了年龄、性别、糖尿病(DM)、高血压(HT)、BMI、Pfirrmann 椎间盘退变类型、突出类型(膨出、突出、游离)和手术节段。

结果

组 1 和组 2 的平均年龄分别为 48.93±13.47 岁和 44.4±11.79 岁,差异无统计学意义(P=0.064)。性别分布也无显著差异,组 1 中男性占 63.41%,组 2 中占 56.16%(P=0.450)。两组 DM 患病率相似(P=0.727)。值得注意的是,组 2 中 HT 明显较低(P=0.018)。两组平均 BMI 相当(P=0.607),Pfirrmann 椎间盘退变评分无显著差异(P=0.547)。影像学椎间盘类型分布无显著差异(P=0.448)。两组大多数手术均在 L4-5 水平进行,手术水平无显著差异(P=0.456)。

结论

我们发现性别、年龄、DM、肥胖、手术水平、椎间盘退变和椎间盘类型等因素对 RLDH 无显著影响。然而,复发病例中 HT 的发生率较高表明有进一步研究的潜在领域。

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