经椎间孔入路脊柱内镜治疗腰椎间盘突出症疗效的危险因素分析

RISK FACTORS ANALYSIS FOR TRANSFORAMINAL PERCUTANEOUS ENDOSCOPIC DISCECTOMY IN THE TREAT OF LUMBAR DISC HERNIATION

摘要:

目的：探讨经椎间孔入路脊柱内镜(Transforaminal Percutaneous Endoscopic Discectomy, TPED)治疗腰椎间盘突出症(Lumbar Disc Herniation, LDH)疗效的危险因素。方法：回顾性分析2016年1月-2017年7月行 TPED治疗的LDH患者400例,随访12月,根据改良MacNab疗效评价手术疗效,疗效优、良者入(G)组,疗效可、差者入(B)组。收集两组患者年龄、性别、体重指数(Body Mass Index, BMI)、腰椎外伤史、病程、症状、节段、椎间盘退变Pfirrmann分级、椎管形态、突出物钙化及腰椎失稳等临床参数进行单因素分析。对单因素分析有统计学意义的临床参数行Logistic多因素分析。结果：400例患者中G组共368例,B组共32例。单因素分析显示患者病程、症状、椎管形态、突出物钙化有统计学意义。Logistic多因素分析显示患者病程(OR=2.500,P=0.022)、症状(OR=4.478,P=0.000)、椎管形态(OR=2.230,P=0.039)、突出物钙化(OR=3.026,P=0.010)为影响TPED治疗LDH疗效的独立危险因素。结论：患者的病程、症状、椎管形态、突出物钙化是影响TPED治疗LDH疗效的独立危险因素。

Abstract:

Objective: To explore the risk factors of the efficacy of Transforaminal Percutaneous Endoscopic Discectomy (TPED) in the treatment of lumbar disc herniation (LDH). Methods: This was a retrospectively study. 400 LDH patients treated with TPED from January 2016 to July 2017 were enrolled. All patients were followed up for 12 months and divided into group G and B according to the modified MacNab criteria. The clinical parameters of age, gender, body mass index (BMI), history of lumbar trauma, course of disease, symptoms, segments, Pfirrmann disc degeneration grade, spinal canal morphology, protrusion calcification and lumbar instability were collected for univariate analysis. Logistic analysis was performed on the parameters with statistical significance in univariate analysis. Results: Among the 400 LDH patients, 368 patients in G group, and 32 parients in B group. Univariate analysis showed that the course of disease, symptoms, spinal canal morphology and protrusion calcification had statistical significance. Logistic analysis showed that the course of disease (OR=2.500, P=0.022), symptoms (OR=4.478, P=0.000), spinal canal morphology (OR=2.230, P=0.039), protrusion calcification (OR=3.026, P=0.010) were independent risk factors affecting the efficacy of TPED in the treatment of LDH. Conclusions: The course of disease, symptoms, spinal canal morphology and protrusion calcification are the independent risk factors affecting the efficacy of TPED in the treatment of LDH.