影响经皮椎间孔入路内镜下神经根减压治疗腰椎管狭窄症临床疗效的相关因素分析*

Analysis of related factors for percutaneous endoscopic nerve root decompression via transforaminal approach onlumbar spinal stenosis*

摘要:

摘要：目的 分析影响经皮椎间孔入路内镜下神经根减压治疗腰椎管狭窄症临床疗效的相关因素。方法 回顾性分析2016年5月－2017年1月105例有完整随访记录的单节段腰椎管狭窄症患者，表现为单侧神经根症状，行经皮椎间孔入路内镜下神经根减压治疗，采用Oswestry功能障碍指数（ODI）评估手术疗效。对可能影响手术疗效的9个指标进行单因素分析，选取其中有统计学意义的指标进行Logistic回归分析。结果 单因素分析显示：年龄、性别、跛行距离、病变节段分布、狭窄区域、椎间孔面积与手术疗效无明显相关（P >0.05）；而病程、术前ODI评分及侧隐窝矢状径与手术疗效相关（P <0.05）。Logistic回归分析显示：病程和术前ODI评分为独立预后因素。结论 病程、术前ODI评分及侧隐窝矢状径是影响手术疗效的相关因素，其中病程和术前ODI评分为独立预后因素。

Abstract:

Abstract: Objective To investigate related factors for percutaneous endoscopic nerve root decompression via transforaminal approach on lumbar spinal stenosis. Methods From May 2016 to January 2017, 105 cases of single segment lumbar spinal stenosis who had completed follow-up data were involved. All the patients had unilateral lower extremity neurological symptoms, and underwent percutaneous endoscopic nerve root decompression via transforaminal approach. The operative effect was assessed according to Oswestry Disability Index (ODI). Firstly, single factor analysis was used in 9 clinical variables that might influence the surgical effect, including age, gender, duration of disease, claudication distance, preoperative ODI scores, segmental distribution, stenosis area, stenosis grade (the radius vector of lateral recesses and intervertebral foramen area). Then, Logistic regression analysis was performed to the indexes with statistical significance. Results Single factor analysis showed that age, gender, claudication distance, segmental distribution, stenosis area, intervertebral foramen area were not significantly correlated with operative effect (P > 0.05). While duration of disease, preoperative ODI scores and radius vector of lateral recesses were significantly correlated with operative effect (P < 0.05). Logistic regression analysis showed that duration of disease and preoperative ODI scores were the major factors influencing the operative effect. Conclusion Duration of disease, preoperative ODI scores and radius vector of lateral recesses were the related factors that affect the surgical effect. Of which, duration of disease and preoperative ODI scores were the major factors influencing the operative effect.