Li Yuanmei, Song Huijuan, Zhou Hongzhen, Zhou Jungui, Zhou Zhou
Southern Medical University, Nanfang Hospital, Department of Rehabilitation Medicine - Guangzhou, China.
Southern Medical University, Nanfang Hospital, Department of Nursing - Guangzhou, China.
Rev Assoc Med Bras (1992). 2025 Mar 17;71(1):e20240902. doi: 10.1590/1806-9282.20240902. eCollection 2025.
The objective of this study was to compare the long-term efficacy of spinal fusion surgery versus non-surgical treatment for chronic radicular lumbar spondylopathy.
A total of 93 patients with chronic radicular lumbar spondylopathy admitted to our hospital from February 2020 to February 2021 were randomly divided into a non-surgical group (n=46, conservative treatment) and a surgical group (n=47, spinal fusion surgery). Efficacy, recurrence rate, pain index, lumbar function recovery, and quality of life were evaluated and compared between the groups.
The surgical group had a higher total effective rate (97.87 vs. 86.96%, p<0.05) and a lower recurrence rate after 1 year (4.26 vs. 21.74%, p<0.05) compared to the non-surgical group. There was no significant difference in visual analog scale scores for lower back pain and lower limb pain between the groups before treatment and for the first 3 days (p>0.05). However, at 1 month, 3 months, and 1 year after treatment, the visual analog scale scores were significantly lower in the surgical group (p<0.05). The Japanese Orthopedic Association score showed no significant difference before treatment (p>0.05) but increased significantly in the surgical group after 1 month, 3 months, and 1 year (p<0.05). Similarly, there was no significant difference in the Short Form 36-Item Health Survey score before treatment (p>0.05), but the surgical group had significantly higher scores after 1 year (p<0.05).
Spinal fusion surgery offers better long-term efficacy than non-surgical treatment for chronic radicular lumbar spondylopathy. It effectively alleviates lower back and limb pain, promotes lumbar function recovery, and improves quality of life, making it a recommended treatment option.
本研究的目的是比较脊柱融合手术与非手术治疗慢性根性腰椎病的长期疗效。
2020年2月至2021年2月我院收治的93例慢性根性腰椎病患者随机分为非手术组（n = 46，保守治疗）和手术组（n = 47，脊柱融合手术）。对两组的疗效、复发率、疼痛指数、腰椎功能恢复情况及生活质量进行评估和比较。
与非手术组相比，手术组的总有效率更高（97.87%对86.96%，p<0.05），1年后复发率更低（4.26%对21.74%，p<0.05）。治疗前及治疗后前3天，两组下腰痛和下肢疼痛的视觉模拟评分无显著差异（p>0.05）。然而，治疗后1个月、3个月和1年，手术组的视觉模拟评分显著更低（p<0.05）。日本骨科协会评分在治疗前无显著差异（p>0.05），但手术组在1个月、3个月和1年后显著升高（p<0.05）。同样，治疗前36项简短健康调查评分无显著差异（p>0.05），但手术组1年后评分显著更高（p<0.05）。
对于慢性根性腰椎病，脊柱融合手术比非手术治疗具有更好的长期疗效。它能有效缓解下背部和肢体疼痛，促进腰椎功能恢复，提高生活质量，是推荐的治疗选择。
