| 张刚,高晓平,陈和木,等.神经根沉降征与腰椎间盘突出症的相关性研究[J].安徽医药,2016,20(5):883-886. |
| 神经根沉降征与腰椎间盘突出症的相关性研究 |
| Correlation between the nerve root sedimentation and the lumbar disc herniationZHANG Gang,GAO Xiao-ping,CHENG He-mu,et al (The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China) Abstract:Objective |
| 投稿时间：2016-02-18 |
| DOI： |
| 中文关键词: 椎间盘移位 磁共振成像 神经根病 物理治疗技术 |
| 英文关键词: Intervertebral Disc Displacement Magnetic Resonance Imaging Radiculopathy Physical Therapy Modalities |
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| 中文摘要: |
| 目的 探讨神经根沉降征与腰椎间盘突出症(LDH)的相关性及其对腰椎间盘突出症患者保守治疗效果的预判作用。 方法 选取68例L4/5椎间盘突出患者作为研究对象,按神经根沉降征是否阳性分为A组(阳性组)36例,B组(阴性组)32例。对A、B两组患者进行年龄、性别、病程、硬膜囊受压面积比及VAS评分、JOA评分比较。再予以两组患者相同的保守治疗1个月,观察两组疗效是否存在差异。 结果 两组患者的性别、年龄及病程的比较差异无统计学意义(P均>0.05)；两组患者的硬膜囊受压面积比差异有统计学意义(P<0.05),A组病例整体的硬膜囊压迫程度较B组重,当硬膜囊受压面积比>25%时,出现阳性神经根沉降的病例明显增多；两组间治疗前VAS评分、JOA评分比较差异无统计学意义(P>0.05)；治疗后两组VAS评分比较,差异无统计学意义(P>0.05),JOA评分比较,治疗后B组JOA评分高于A组(P<0.05)；两组VAS的显效率比较差异无统计学意义(P>0.05),两组JOA的显效率比较,差异有统计学意义(P<0.05),提示B组疗效优于A组。 结论 神经根沉降征阳性与阴性患者的性别、年龄、病程及VAS评分、JOA评分无差异；硬膜囊受压面积越大,神经根沉降征阳性率越高。神经根沉降症阳性的LDH患者保守治疗效果较阴性者差,提示神经根沉降征可能作为一个预测LDH患者保守治疗效果的指标。 |
| 英文摘要: |
| Objective To investigate the correlation between nerve root sedimentation and lumbar disc herniation and the role of nerve root sedimentation in predicting the effect of conservative treatment for lumbar disc herniation. Methods 68 patients diagnosed with L4/5 disc herniation at the rehabilitation were selected,in which 36 cases were divided into Agroup ( Positive group) and 32 cases were into Bgroup (Negative group) according to whether accompanying with nerve root sedimentation.Besides comparison of general information,JOA score and VAS score between Aand Bgroup,the two groups both received conservative treatment for one month as well,then whether there was a discrepancy of effect in two groups after treatment was evaluated. Results There was no statistical difference in sex,age and course of disease between the two groups(P>0.05).However,the comparison of the ratio of dural sac compression area between the two groups was significantly different.the dural sac compression degree of patients in group Awas universally much severer than that of patients in group B.When the ratio was more than 25%,the number of LDH patients accompanied with positive nerve root sedimentation significantly increased(P<0.05).The discrepancy of VAS score between the two groups neither before treatment nor after one month treatment wasn’t statistically significant(before:t=0.755,P>0.05,after:Z=-0.15,P>0.05),which suggested the VAS score couldn’t be an available indicator of the existing nerve root sedimentation.There was no significant difference in JOA score between the two groups before treatment(t=-0.149,P>0.05),however,the discrepancy of JOA score between the two groups after one month treatment was statistical significance(t=-3.388,P<0.05),however,there was no significant difference in VAS score between the two groups(P>0.05),but the JOA score after treatment in Bgroup was notably higher than that in Agroup.There was no difference in the effective rate of VAS between the two groups after treatment(χ2=0.008, P>0.05)； whereas,there was a significant difference in the effective rate of JOA between the two groups after treatment(χ2=5.110,P<0.05),in which the effective rate of JOA in Bgroup was better than that in Agroup. Conclusions Nerve root sedimentation was no significant difference in sex,age and course of disease VAS score and JOA score between positive group and negative group.The more severer of the dural sac compression degree of patients was,the more possibilities of the nerve root sedimentation appeared.The effect of conservative treatment for lumbar disc herniation accompanying with nerve root sedimentation is really poorer than that for single lumbar disc herniation,which demonstrated the nerve root sedimentation might be an useful indicator for predicting the effect of conservative treatment for lumbar disc herniation. |
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