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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Lumbar microdiscectomy: a clinicoradiological analysis of outcome.
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Lumbar microdiscectomy: a clinicoradiological analysis of outcome.

机译：腰椎间盘切除术：预后的临床放射学分析。

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BACKGROUND: The long-term outcome after lumbar microdiscectomy (LMD) may be affected by low back pain (LBP) and segmental instability, the determinants of which remain unclear. We sought to analyze the interaction between clinical, functional, and radiological variables and their impact on patient outcome. METHODS: All patients who underwent LMD in 2004-2005 were invited to participate in this retrospective cohort study. Patients were re-evaluated clinically and radiologically after a three to five year follow-up. RESULTS: Forty-one of 97 eligible patients were enrolled. Twelve patients (29.3%) reported moderate-to-severe sciatica, 12 (29.3%) had moderate LBP, and 13 (31.7%) exhibited clinical evidence of segmental instability. Thirty-eight patients (92.7%) had minimal disability and 3 (7.3%) had moderate disability. Twenty-three patients (56.1%) were fully satisfied, while 18 (43.9%) had only partial satisfaction, having expected a better outcome. Thirty-three patients (80.5%) returned to full-time work. Median disc space collapse (DSC) was 20% (range 5-66%) and L4-L5 was particularly affected. Prevalence of Modic changes increased from 46.3% to 78% with type 2 predominance. Multivariate logistic regression analysis identified the following negative prognostic factors: female sex, young age, lack of regular exercise, and chronic preoperative LBP. There was no correlation between the course of Modic changes, DSC, and patient outcome. CONCLUSION: Although many patients may be symptomatic following LMD, significant disability and dissatisfaction are uncommon. Female sex, young age, lack of exercise, and chronic preoperative LBP may predict a worse outcome. Disc collapse is a universal finding, particularly at L4-L5. Neither DSC nor Modic changes seem to affect patient outcome.
机译：背景：腰椎间盘切除术（LMD）的长期预后可能受到下腰痛（LBP）和节段性不稳定性的影响，其决定因素仍不清楚。我们试图分析临床，功能和放射学变量之间的相互作用及其对患者预后的影响。方法：所有2004-2005年接受LMD的患者均被邀请参加这项回顾性队列研究。在三到五年的随访之后，对患者进行了临床和放射学重新评估。结果：纳入97名合格患者中的41名。 12名患者（29.3％）报告为中度至重度坐骨神经痛，12名（29.3％）患有中度LBP，13名（31.7％）表现出节段性不稳定的临床证据。 38例患者（92.7％）的轻度残疾，3例（7.3％）的中度残疾。 23名患者（56.1％）完全满意，而18名（43.9％）仅部分满意，并预期效果会更好。 33名患者（80.5％）返回全职工作​​。椎间盘间隙塌陷（DSC）的中位数为20％（范围为5-66％），L4-L5受到的影响特别大。 2型占主导地位的Modic改变的患病率从46.3％增加到78％。多元logistic回归分析确定了以下不良预后因素：女性，年轻，缺乏定期运动和慢性术前LBP。 Modic改变，DSC和患者预后之间没有相关性。结论：尽管许多患者可能在LMD后出现症状，但严重的残疾和不满并不常见。女性，年轻，缺乏运动和慢性术前LBP可能预示较差的结果。椎间盘塌陷是一个普遍的发现，尤其是在L4-L5。 DSC和Modic改变似乎都不会影响患者预后。

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