| 神经电生理变化对腰椎退行性疾病临床表现及手术预后的影响 |
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投稿时间：2022-11-09
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| 作者 | Author | 单位 | Address | E-Mail |
| 陈道东 |
CHEN Dao-dong |
新乡市中心医院 新乡医学院第四临床学院, 河南 新乡 453000 |
Xinxiang Central Hospital, the Fourth Clinical College of Xinxiang Medical College, Xinxiang 453000, Henan, China |
532025327@qq.com |
| 周大凯 |
ZHOU Da-kai |
新乡市中心医院 新乡医学院第四临床学院, 河南 新乡 453000 |
Xinxiang Central Hospital, the Fourth Clinical College of Xinxiang Medical College, Xinxiang 453000, Henan, China |
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| 李慧宁 |
LI Hui-ning |
新乡市中心医院 新乡医学院第四临床学院, 河南 新乡 453000 |
Xinxiang Central Hospital, the Fourth Clinical College of Xinxiang Medical College, Xinxiang 453000, Henan, China |
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| 王亚琳 |
WANG Ya-lin |
新乡市中心医院 新乡医学院第四临床学院, 河南 新乡 453000 |
Xinxiang Central Hospital, the Fourth Clinical College of Xinxiang Medical College, Xinxiang 453000, Henan, China |
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| 朱振军 |
ZHU Zhen-jun |
新乡市中心医院 新乡医学院第四临床学院, 河南 新乡 453000 |
Xinxiang Central Hospital, the Fourth Clinical College of Xinxiang Medical College, Xinxiang 453000, Henan, China |
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| 期刊信息：《中国骨伤》2023年，第36卷，第7期，第686-691页 |
| DOI：10.12200/j.issn.1003-0034.2023.07.017 |
| 基金项目: |
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中文摘要:
目的：评估肌电图对腰椎退行性疾病临床表现及其后路椎体间融合术（posterior lumbar interbody fusion，PLIF）预后的影响。
方法：回顾性分析2018年1月至2019年10月行肌电图检查的腰椎退行性疾病患者68例，男29例，女39例，年龄21~84岁。根据术前肌电图结果将患者分为：肌电图结果正常者为阴性组32例，异常者为阳性组36例，两组都行PLIF手术。比较两组术前患病时间、术后恢复时间、手术时间、术中出血量、下床活动时间及住院时间；比较术前后的腰疼、腿疼视觉模拟评分（visual analogue scale，VAS）、日本骨科协会评分（Japanese Orthopaedic Association，JOA）评分。
结果：68例获随访，时间26~39个月。在术后各时间段两组腰疼、腿疼VAS都明显小于术前。两组术后JOA评分中主观症状、临床体征、日常活动评分及JOA总分都明显大于术前（P<0.05）；术后3个月阴性组JOA中临床体征评分、JOA总评分都大于阳性组（P<0.05）；术后1、3个月阴性组腿疼VAS小于阳性组（P<0.05）；阴性组患者患病时间、术后恢复时间、住院时间及下床时间都短于阳性组（P<0.05）。在其他时间点，两组的腰痛VAS、腿疼VAS、JOA评分比较差异无统计学意义（P>0.05）。两组手术时间、术中出血量差异无统计学意义（P>0.05）。
结论：肌电图正常较肌电图异常腰椎退行性疾病患者患病时间短；PLIF术后，肌电图正常患者较肌电图异常患者恢复快，但肌电图的结果对PLIF手术最终预后无影响。 |
| 【关键词】肌电图 腰椎退行性疾病 经后路椎体间融合术 预后 |
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| Effect of neuroelectrophysiological changes on the clinical manifestations and surgical outcomes of lumbar degenerative diseases |
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ABSTRACT
Objective To evaluate the effects of electromyography on the clinical manifestations and prognosis after posterior lumbar interbody fusion(PLIF) of degenerative lumbar diseases.
Methods A retrospective analysis was performed on 68 patients with degenerative lumbar diseases, including 29 males and 39 females, aged 21 to 84 years old, who underwent electromyogram (EMG) from January 2018 to October 2019. The patients were divided into negative and positive groups according to whether the results of EMG was normal or abnormal, PLIF surgery was performed in both groups. The preoperative duration of illness, postoperative recovery time, operative time, intraoperative blood loss, postoperative ambulation time and length of postoperative hospital stay were recorded. The clinical efficacy was evaluated by visual analogue scale(VAS) of low back and lower limb, the Japanese Orthopedic Association(JOA) score before and after operation.
Results All patients were follow-up from 26 to 39 months. The subjective symptoms, clinical signs, daily activities and JOA total scores after operation in two groups were significantly higher than those before preoperation(P<0.05);the clinical signs score and total JOA score in the negative group at 3 months after operation were higher than those in the positive group(P<0.05). The VAS score of leg pain in the negative group after 1 and 3 months was less than that in the positive group(P<0.05). Patients 's illness time, postoperative recovery time, hospitalization time and implantation time in the negative group were shorter than those in the positive group(P<0.05). At other time points, there was no significant difference in low pain VAS, leg pain VAS, JOA scores in the two groups(P>0.05). There was no significant difference in the operation time and intraoperative bleeding volume between the two groups(P>0.05).
Conclusion Patients with normal electromyography had shorter disease duration than ones with abnormal electromyography in lumbar degenerative disease;after PLIF, patients with normal electromyography recovered faster than ones with abnormal electromyography, but the results of electromyography had no effect on the final prognosis of PLIF surgery. |
| KEY WORDS Electromyography Lumbar degenerative disease Posterior lumbar interbody fusion Prognosis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈道东,周大凯,李慧宁,王亚琳,朱振军.神经电生理变化对腰椎退行性疾病临床表现及手术预后的影响[J].中国骨伤,2023,36(7):686~691 |
| 英文格式: | CHEN Dao-dong,ZHOU Da-kai,LI Hui-ning,WANG Ya-lin,ZHU Zhen-jun.Effect of neuroelectrophysiological changes on the clinical manifestations and surgical outcomes of lumbar degenerative diseases[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(7):686~691 |
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