CAJ | 학술논문

目的探讨腰椎间盘突出症患者手术时机对术后疗效的影响.方法采用回顾性对比研究的方法,以12个月为手术时机时限,将85例因腰椎间盘突出症行微创腰椎间盘切除术的患者分为A组43例(≥12个月)和B组42例(＜12个月),对术前及术后下肢疼痛视觉模拟评分(VAS)、功能障碍指数(ODI)评分及日本整型外科学会(JOA)评分改善率进行统计学分析.结果本研究共对85例患者进行了随访调查.术前症状持续时间A组36.0(12.0,84.0)个月,B组2.5(2.0,4.2)个月.下肢疼痛VAS评分A组术前为6.0(5.0,8.0)分,术后为1.0(0.0,1.0)分;B组术前为5.0(4.8,8.0)分,术后为0.0(0.0,2.0)分.2组对比,术前(t =0.868,P=0.390);术后(t=1.530,P=0.133),差异无统计学意义.ODI评分A组术前为57.0％ (42.0％,75.0％),术后为15.0％(8.0％,21.0％);B组术前为57.5％ (44.2％,76.0％),术后为11.0％(4.8％,18.0％).2组对比,术前(t=-0.396,P=0.694);术后(t=1.399,P=0.169),差异无统计学意义.JOA评分改善率A组(78±24)％,B组(86±17)％,t=-1.322,P=0.193,差异无统计学意义.结论微创腰椎间盘切除术治疗腰椎间盘突出症疗效是肯定的.本研究选取12个月作为手术时机时限进行回顾性对比分析,发现术后疗效差异无统计学意义.
목적 탐토요추간반돌출증환자수술시궤대술후료효적영향.방법 채용회고성대비연구적방법,이12개월위수술시궤시한,장85례인요추간반돌출증행미창요추간반절제술적환자분위A조43례(≥12개월)화B조42례(＜12개월),대술전급술후하지동통시각모의평분(VAS)、공능장애지수(ODI)평분급일본정형외과학회(JOA)평분개선솔진행통계학분석.결과 본연구공대85례환자진행료수방조사.술전증상지속시간A조36.0(12.0,84.0)개월,B조2.5(2.0,4.2)개월.하지동통VAS평분A조술전위6.0(5.0,8.0)분,술후위1.0(0.0,1.0)분;B조술전위5.0(4.8,8.0)분,술후위0.0(0.0,2.0)분.2조대비,술전(t =0.868,P=0.390);술후(t=1.530,P=0.133),차이무통계학의의.ODI평분A조술전위57.0％ (42.0％,75.0％),술후위15.0％(8.0％,21.0％);B조술전위57.5％ (44.2％,76.0％),술후위11.0％(4.8％,18.0％).2조대비,술전(t=-0.396,P=0.694);술후(t=1.399,P=0.169),차이무통계학의의.JOA평분개선솔A조(78±24)％,B조(86±17)％,t=-1.322,P=0.193,차이무통계학의의.결론 미창요추간반절제술치료요추간반돌출증료효시긍정적.본연구선취12개월작위수술시궤시한진행회고성대비분석,발현술후료효차이무통계학의의.
Objective To evaluate whether an optimistic operation time can change the outcomes of the lumbar disc herniation patients.Methods A total of 85 patients with lumbar disc herniation treated by minimal invasive discectomy were reviewed.Surgery was performed when leg pain persisted even with adequate conservative treatment.The patients were divided into two groups according to the duration of symptoms before surgery:the group A were the patients having symptoms for over or equal to 12 months and the group B were the patients having symptoms for fewer than 12 months.Leg pain visual analogue scale(VAS),the oswestry disability index (ODI) and lumbar Japanese orthopaedic association (JOA) score were assessed and compared before and after surgery.Results There were 43 patients in group A and 42 patients in group B.The duration of symptoms was 36.0 (12.0,84.0) months in group A and 2.5 (2.0,4.2) months in group B.No significant differences were found between the groups in terms of patient demographics (age,sex,body mass index,type of herniation),surgical time and blood loss.There were no significant differences of VAS between the groups.The VAS scores before operation were group A 6.0(5.0,8.0) vs group B 5.0(4.8,8.0) (t =0.868,P =0.390),while the post-operation VAS were group A 1.0 (0.0,1.0) vs group B 0.0 (0.0,2.0) (t =1.530,P =0.133).There were no significant differences of ODI scores between the groups.The pre-operation ODI scores were group A 57.0％ (42.0％,75.0％) vs group B 57.5％ (44.2％,76.0％) (t =-0.396,P =0.694),while the post-operation ODI scores were group A 15.0％ (8.0％,21.0％) vs group B 11.0％ (4.8％,18.0％) (t =1.399,P =0.169).In addition,there were no significant differences between group A and group B based on lumbar JOA scores:group A (78 ±24)％ vs group B (86 ± 17)％ (t =-1.322,P =0.193).Conclusions The minimal invasive discectomy is effective treating the lumbar disc herniation.Early surgical intervention (＜ 12 months) does not result in signif-icant imorovement of clinical outcomes for patients with lumbar disc herniation.