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腰椎间盘突出症的回顾性研究:临床病例与治疗方案分析

A Retrospective Study of Lumbar Disk Herniation: An Analysis of Clinical Cases and Treatment Plans.

作者信息

Duceac Covrig Mădălina, Guțu Cristian, Pleșea-Condratovici Alina, Duceac Letiția Doina, Eva Lucian, Dabija Marius Gabriel, Elkan Eva-Maria, Miftode Alina Monica, Stefanache Alina, Dabija Vlad-Andrei, Calin Gabriela, Voinescu Doina Carina

机构信息

Faculty of Medicine and Pharmacy, "Dunărea de Jos" University Galaţi, Al. I. Cuza Street, Nr. 35, 800008 Galați, Romania.

"Prof. Dr. Nicolae Oblu" Emergency Clinical Hospital, 2 Ateneului Street, 700309 Iași, Romania.

出版信息

J Clin Med. 2025 Jun 3;14(11):3952. doi: 10.3390/jcm14113952.

Abstract

: One common musculoskeletal disorder seriously compromising quality of life and burdening healthcare systems is lumbar disk herniation (LDH). LDH affects quality of life, healthcare costs, and occupational productivity, and it is expected to affect 40% of the population, mostly between 30 and 50 years of age. : Over three years, this research assessed treatment results and the effect of comorbidities in a sample of 3074 individuals. : Surgical treatments-especially microdiscectomy-have a high success rate; over 90% of patients said their pain and functioning six months after surgery had improved significantly. Comparatively, conservative treatment approaches-physical therapy and epidural steroid injections-showed about 60% success in 70% of patients, indicating a clear need for early surgical assessment since 25% of originally conservatively managed patients needed surgery within one year. Significantly affecting treatment success are demographic variables; patients with preoperative Oswestry Disability Index (ODI) scores above 50 saw a 40-point improvement post-surgery compared to a 20-point gain for those following conservative therapy. High comorbidity rates-including obesity (mean of 148.33) and cardiovascular illnesses (mean of 530.33)-that are associated with extended recovery durations and complications were also seen in this research. : Our results support a customized treatment plan, stressing the need of integrating thorough rehabilitation plans with prompt surgical interventions to maximize patient outcomes. This study emphasizes the need for a patient-centered treatment paradigm in controlling LDH, thereby trying to improve recovery and lower the healthcare load.

摘要

一种严重影响生活质量并给医疗系统带来负担的常见肌肉骨骼疾病是腰椎间盘突出症(LDH)。腰椎间盘突出症会影响生活质量、医疗成本和职业生产力,预计会影响40%的人口,大多数患者年龄在30至50岁之间。在三年时间里,这项研究评估了3074名患者样本的治疗结果和合并症的影响。手术治疗——尤其是显微椎间盘切除术——成功率很高;超过90%的患者表示术后六个月他们的疼痛和功能有了显著改善。相比之下,保守治疗方法——物理治疗和硬膜外类固醇注射——在70%的患者中显示出约60%的成功率,这表明显然需要进行早期手术评估,因为25%最初接受保守治疗的患者在一年内需要手术。显著影响治疗成功率的是人口统计学变量;术前奥斯威斯残疾指数(ODI)得分高于50分的患者术后提高了40分,而接受保守治疗的患者提高了20分。这项研究还发现了高合并症率,包括肥胖(平均148.33)和心血管疾病(平均530.33),这些合并症与恢复时间延长和并发症有关。我们的结果支持定制治疗方案,强调需要将全面的康复计划与及时的手术干预相结合,以最大限度地提高患者的治疗效果。这项研究强调了在控制腰椎间盘突出症方面需要以患者为中心的治疗模式,从而努力改善康复情况并减轻医疗负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cf5/12155853/64361726b24d/jcm-14-03952-g001.jpg

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