退变性腰椎侧弯伴椎管狭窄症的神经根性痛与侧弯的关系

发布时间：2018-04-28 06:07

  本文选题：侧弯 + 退变　； 参考：《青岛大学》2015年硕士论文

【摘要】：目的:研究伴有椎管狭窄的退变性腰椎侧弯下肢神经根性痛与侧弯的关系。方法:收集我院2009/01-2014/01间退变性腰椎侧弯伴椎管狭窄症患者100例,男33例,女67例,年龄50-81岁,平均64.3岁。通过症状及体征、体格检查、影像学检查确定受累神经根的受压部位,测量腰椎侧凸冠状位Cobb角、并统计下腰痛JOA评分及ODI评分,末次随访时仍需测量上述指标。结果:1、术前Cobb角19.13°±8.03,JOA评分10.84±3,35,ODI评分36.09±1.38,术后末次随访依次为8.07°±2.64,23.54±2.73,7.19±0.85,手术前后比较都有统计学意义(t=14.55,t=31.19,t=192.56,p0.01)。2、本研究受累神经根为L3(17,7.5%)、L4(78,35%)、L5(109,49%)、S1(20,8.5%),L3、L4、L5、S1神经根位于侧弯凹侧分别为9(53%)、54(69%)、35(32%)、8(40%)条,位于侧弯凸侧分别为8(47%)、24(31%)、74(68%)、12(60%)条,L4神经根多在侧凸凹侧受压,L5神经根多在凸侧受压(118.252x?,p0.001),L4、L5神经根受压明显多于L3、S1神经根(107.1092x?,p0.001).3、症状与主弯(814.32x?,p0.05)及代偿弯(324.12x?,p0.05)无关。结论:退变性腰椎侧弯伴椎管狭窄症患者的神经根受压情况复杂多样,L4神经根症状多位于凹侧,L5神经根症状多位于凸侧,L4、L5神经根受压情况明显多于L3、S1神经根。该病侧弯方向与顶椎明显相关,顶椎位于L3椎体的大多左凸,症状与侧弯方向、主弯及代偿弯不相关,根据临床症状选择性的对主弯或代偿弯进行校正至关重要,明显提高患者长远的生活质量。
[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. 缁撴灉:1,鏈�鍓岰obb瑙，

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