敖鹏;吴添龙;张磊磊;李建;姚玉龙;邓中博;程子韵;程细高;

• 1:江西省骨科研究所南昌大学第二附属医院骨科

摘要(Abstract)：

[目的]探讨神经根沉降征在腰椎管狭窄症术后的价值以及手术前后神经根沉降征的改变与手术疗效的关系。[方法]选择2012年2月~2014年2月因腰腿痛或间歇性跛行于本院就诊住院并且行手术治疗的患者362例进行电话等形式的回访。共收集到来院进行术后MRI复查的患者37例。平均年龄46.3岁:其中男16例,女21例。86.5%的患者病变节段位于L_(4、5)椎间盘,8.1%位于L_(3、4)椎间盘,5.4%位于L_(2、3)椎间盘。记录患者术前术后JOA评分、VAS评分、Oswestry功能障碍指数并进行比较。[结果]术后复查患者术前神经根沉降征阳性35例,假阴性2例,术后神经根沉降征阴性37例。神经根沉降征阳性者术后JOA评分、VAS评分、ODI评分与术前相比,差异有统计学意义(P<0.05)。[结论]神经根沉降征在腰椎管狭窄术后诊断依然适用;术前神经根沉降征阳性诊断的腰椎管狭窄节段行手术治疗后复查MRI见神经根沉降征阴性且患者症状明显好转。

关键词(KeyWords)： 磁共振;神经根沉降征;腰椎管狭窄;术后

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(编号:81060147)

作者(Author): 敖鹏;吴添龙;张磊磊;李建;姚玉龙;邓中博;程子韵;程细高;

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DOI:

参考文献(References)：

• [1]Verbiest H.A radicular syndrome from developmental narrowing of the lumbar vertebral canal[J].Clin Orthop,2001,36B(384):3-9.
• [2]Amundsen T,Weber H,Lilleas F,et al.Lumbar spinal stenosis.Clinical and radiologic features[J].Spine,1995,20(20):1178-1186.
• [3]Barz T,Melloh M,Staub L,et al.The diagnostic value of a treadmill test in predicting lumbar spinal stenosis[J].Eur Spine J,2008,17(5):686-690.
• [4]Chiodo A,Haig AJ,Yamakawa KS,et al.Magnetic resonance imaging vs.electrodiagnostic root compromise in lumbar spinal stenosis:a masked controlled study[J].Am J Phys Med Rehabil,2008,87(10):789-797.
• [5]Kanno H,Ozawa H,Koizumi Y,et al.Dynamic change of dural sac cross-sectional area in axial loaded magnetic resonance imaging correlates with the severity of clinical symptoms in patients with lumbar spinal canal stenosis[J].Spine,2012,37(3):207-213.
• [6]Konno S,Hayashino Y,Fukuhara S,et al.Development of a clinical diagnosis support tool to identify patients with lumbar spinal stenosis[J].Eur Spine J,2007,16(11):1951-1957.
• [7]Sirvanci M,Bhatia M,Ganiyusufoglu KA,et al.Degenerative lumbar spinal stenosis:correlation with oswestry disability index and MR imaging[J].Eur Spine J,2008,17(5):679-685.
• [8]Barz T,Melloh M,Staub LP,et al.Nerve root sedimentation sign:evaluation of a new radiological sign in lumbar spinal stenosis[J].Spine,2010,35(8):892-897.
• [9]Andreisek G,Imhof M,Wertli M,et al.A systematic review of semiquantitative and qualitative radiologic criteria for the diagnosis of lumbar spinal stenosis[J].AJR Am J Roentgenol,2013,201(5):735-746.
• [10]Steurer J,Roner S,Gnannt R,et al.Quantitative radiologic criteria for the diagnosis of lumbar spinal stenosis:a systematic literature review[J].BMC Musculoskelet Disord,2011,12(1):175.
• [11]Rachel A,Moses MD,Wenyan Z,et al.Is the sedimentation sign associated with spinal stenosis surgical treatment effect in SPORT[J].Spine(Phila Pa1976),2015,40(3):129-136.
• [12]李群峰.退行性腰椎管狭窄症采用腰椎后路减压内固定融合术的疗效分析[J].中国实用神经疾病杂志,2014,17(17):97-99.
• [13]Azimi P,Rezaei O,Montazeri A.An outeome measure of functionality and guality of cife in patients with cerrical myelo path[J].Iran Red Cresent Med J,2014,16(6):8102.
• [14]Deyo RA.Treatment of lumbar spinal stenosis:a balancing act[J].Spine J,2010,10(7):625-627.
• [15]Fazal A,Yoo A,Bendo JA.Does the presence of the nerve root sedimentation sign on MRI correlate with the operative level in patients undergoing posterior lumbar decompression for lumbar stenosis[J].Spine J,2013,13(8):837-842.
• [16]Fritz JM,Delitto A,Welch WC,et al.Lumbar spinal stenosis:a review of current concepts in evaluation,management,and outcome measurements[J].Arch Phys Med Rehabil,1998,79(6):700-708.
• [17]Herno A,Airaksinen O,Saari T,et al.Lumbar spinal stenosis:a matched-pair study of operated and nonoperated patients[J].Br J Neurosurg,1996,10(5):461-465.