退變性腰椎側(cè)彎伴椎管狹窄癥的神經(jīng)根性痛與側(cè)彎的關(guān)系
發(fā)布時(shí)間:2018-04-28 06:07
本文選題:側(cè)彎 + 退變; 參考:《青島大學(xué)》2015年碩士論文
【摘要】:目的:研究伴有椎管狹窄的退變性腰椎側(cè)彎下肢神經(jīng)根性痛與側(cè)彎的關(guān)系。方法:收集我院2009/01-2014/01間退變性腰椎側(cè)彎伴椎管狹窄癥患者100例,男33例,女67例,年齡50-81歲,平均64.3歲。通過癥狀及體征、體格檢查、影像學(xué)檢查確定受累神經(jīng)根的受壓部位,測(cè)量腰椎側(cè)凸冠狀位Cobb角、并統(tǒng)計(jì)下腰痛JOA評(píng)分及ODI評(píng)分,末次隨訪時(shí)仍需測(cè)量上述指標(biāo)。結(jié)果:1、術(shù)前Cobb角19.13°±8.03,JOA評(píng)分10.84±3,35,ODI評(píng)分36.09±1.38,術(shù)后末次隨訪依次為8.07°±2.64,23.54±2.73,7.19±0.85,手術(shù)前后比較都有統(tǒng)計(jì)學(xué)意義(t=14.55,t=31.19,t=192.56,p0.01)。2、本研究受累神經(jīng)根為L(zhǎng)3(17,7.5%)、L4(78,35%)、L5(109,49%)、S1(20,8.5%),L3、L4、L5、S1神經(jīng)根位于側(cè)彎凹側(cè)分別為9(53%)、54(69%)、35(32%)、8(40%)條,位于側(cè)彎凸側(cè)分別為8(47%)、24(31%)、74(68%)、12(60%)條,L4神經(jīng)根多在側(cè)凸凹側(cè)受壓,L5神經(jīng)根多在凸側(cè)受壓(118.252x?,p0.001),L4、L5神經(jīng)根受壓明顯多于L3、S1神經(jīng)根(107.1092x?,p0.001).3、癥狀與主彎(814.32x?,p0.05)及代償彎(324.12x?,p0.05)無關(guān)。結(jié)論:退變性腰椎側(cè)彎伴椎管狹窄癥患者的神經(jīng)根受壓情況復(fù)雜多樣,L4神經(jīng)根癥狀多位于凹側(cè),L5神經(jīng)根癥狀多位于凸側(cè),L4、L5神經(jīng)根受壓情況明顯多于L3、S1神經(jīng)根。該病側(cè)彎方向與頂椎明顯相關(guān),頂椎位于L3椎體的大多左凸,癥狀與側(cè)彎方向、主彎及代償彎不相關(guān),根據(jù)臨床癥狀選擇性的對(duì)主彎或代償彎進(jìn)行校正至關(guān)重要,明顯提高患者長(zhǎng)遠(yuǎn)的生活質(zhì)量。
[Abstract]:Objective: to study the relationship between lower extremity neuralgia and scoliosis in degenerative lumbar spine with spinal canal stenosis. Methods: a total of 100 patients with degenerative Lumbar Lumbar Lumbar Syndromes with Spinal Stenosis between 2009 / 01 and 2014 / 01 were collected, 33 males and 67 females, aged 50-81 years, with an average age of 64.3 years. According to the symptoms and signs, physical examination, imaging examination to determine the compressed site of the involved nerve root, to measure the coronal Cobb angle of lumbar kyphosis, and to calculate the JOA score and ODI score of low back pain, the above indexes should still be measured at the last follow-up. 緇撴灉:1,鏈墠Cobb瑙,
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