岳茂兴;西永明;

• 1:青岛大学附属医院崂山院区脊柱外科
• 2:平邑县中医医院

摘要(Abstract)：

[目的]探讨马尾神经沉降征(NRSS)在腰椎管狭窄症(LSS)治疗中的意义。[方法]回顾性分析本院2017年3月～2018年3月98例LSS患者行TLIF术的临床资料,根据MRI下马尾神经形态学分型判定马尾神经是否沉降将所有患者分为阳性组和阴性组,比较两组一般资料、Oswestry残障指数(ODI)和疼痛视觉模拟评分(VAS)及Macnab疗效评级,采用多元逻辑回归分析NRSS的主要影响因素。[结果]在98例LSS患者中,NRSS阳性者79例,占80.61%;NRSS阴性者19例,占19.39%。NRSS阳性与阴性两组比较在性别、年龄、体重、病程以及手术节段的差异无统计学意义(P>0.05)。两组患者间术前ODI评分差异不具有统计学意义(P>0.05);但是,术后3、6个月时,NRSS阳性组的ODI评分显著低于NRSS阴性组,差异均具有统计学意义(P<0.05)。两组患者术前和手术后各时间点VAS评分差异均无统计学意义(P>0.05)。术后6个月Macnab疗效评级阳性组显著优于阴性组(P<0.05)。逻辑回归结果表明,NRSS征主要影响术后3个月ODI评分,术后6个月ODI评分和术后6个月Macnab评级(P<0.05);而对其他因素无影响(P>0.05)。[结论] NRSS阳性常见于LSS患者中,且NRSS阳性者的手术疗效优于阴性者,NRSS可能是预估手术效果的指标。

关键词(KeyWords)： 马尾神经沉降征;腰椎管狭窄症;经孔椎体间融合术

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作者(Author): 岳茂兴;西永明;

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参考文献(References)：

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