| 马尾冗余症在腰椎管狭窄症患者中的临床意义及相关危险因素分析 |
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Received:May 06, 2022
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| 作者 | Author | 单位 | Unit | E-Mail |
| 吴仲宣 |
WU Zhong-xuan |
皖南医学院脊柱外科研究中心 皖南医学院弋矶山医院脊柱骨科, 安徽 芜湖 241001 |
Spine Surgery Research Center of Wannan Medical College, Department of Spine Surgery, Yijishan Hospital, the First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Anhui, China |
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| 肖良 |
XIAO Liang |
皖南医学院脊柱外科研究中心 皖南医学院弋矶山医院脊柱骨科, 安徽 芜湖 241001 |
Spine Surgery Research Center of Wannan Medical College, Department of Spine Surgery, Yijishan Hospital, the First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Anhui, China |
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| 赵泉来 |
ZHAO Quan-lai |
皖南医学院脊柱外科研究中心 皖南医学院弋矶山医院脊柱骨科, 安徽 芜湖 241001 |
Spine Surgery Research Center of Wannan Medical College, Department of Spine Surgery, Yijishan Hospital, the First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Anhui, China |
quanlai1986@126.com |
| 刘晨 |
LIU Chen |
皖南医学院脊柱外科研究中心 皖南医学院弋矶山医院脊柱骨科, 安徽 芜湖 241001 |
Spine Surgery Research Center of Wannan Medical College, Department of Spine Surgery, Yijishan Hospital, the First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Anhui, China |
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| 孙竑洲 |
SUN Hong-zhou |
皖南医学院脊柱外科研究中心 皖南医学院弋矶山医院脊柱骨科, 安徽 芜湖 241001 |
Spine Surgery Research Center of Wannan Medical College, Department of Spine Surgery, Yijishan Hospital, the First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Anhui, China |
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| 耿寅 |
GENG Yin |
皖南医学院脊柱外科研究中心 皖南医学院弋矶山医院脊柱骨科, 安徽 芜湖 241001 |
Spine Surgery Research Center of Wannan Medical College, Department of Spine Surgery, Yijishan Hospital, the First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Anhui, China |
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| 江雨剑 |
JIANG Yu-jian |
皖南医学院脊柱外科研究中心 皖南医学院弋矶山医院脊柱骨科, 安徽 芜湖 241001 |
Spine Surgery Research Center of Wannan Medical College, Department of Spine Surgery, Yijishan Hospital, the First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Anhui, China |
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| 期刊信息：《中国骨伤》2023年36卷，第9期，第890-895页 |
| DOI：10.12200/j.issn.1003-0034.2023.09.018 |
| 基金项目:国家自然科学基金面上项目(编号:81972108);皖南医学院弋矶山医院科技创新团队“攀峰”培育计划和皖南医学院弋矶山医院科研能力“高峰”培育计划项目(编号:PF2019007,GF2019T02,GF2019G07,GF2019G12) |
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目的：探究马尾冗余症(redundant nerve roots,RNRs)在腰椎管狭窄患者中的诊疗意义,并筛选与RNRs相关的危险因素。
方法：回顾性分析2015年4月1日至2020年11月30日196例于皖南医学院弋矶山医院脊柱外科就诊的腰椎管狭窄症患者临床资料。根据是否出现RNRs将所有患者分为RNRs阳性组和RNRs阴性组。比较两组患者一般临床资料、影像学参数、视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI)等指标差异性,利用二元Logistic回归分析筛选与RNRs高度相关的危险因素。
结果：RNRs阳性组59 例,RNRs阴性组137 例。196例腰椎管狭窄症患者RNRs发生率为30.10%(59/196)。两组患者VAS、ODI组间差异有统计学意义(P<0.05),RNRs阳性组患者临床症状较RNRs阴性组重。年龄、狭窄节段数、腰椎硬膜囊面积平均值、最狭窄节段及最狭窄节段硬膜囊面积差异有统计学意义(P<0.05)。二元Logistic回归分析显示狭窄节段数、椎管正中矢状径平均值及腰椎椎间隙硬膜囊面积平均值与RNRs产生与否具有相关性(P<0.05),其中狭窄节段数回归系数为-1.115,椎管正中矢状径回归系数为-1.707,腰椎椎间隙硬膜囊面积平均值回归系数为7.556。
结论：伴有RNRs的腰椎管狭窄症患者临床症状较不伴者明显严重。狭窄节段数、椎管正中矢状径、腰椎椎间隙硬膜囊面积是RNRs发生的高危因素,其中腰椎椎间隙硬膜囊面积相关性最高。 |
| [关键词]:马尾神经冗余症 椎管狭窄症 危险因素 椎间隙硬膜囊面积 |
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| Clinical significance and risk factors of redundant nerve root in patients with lumbar spinal stenosis |
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Abstract:
Objective To investigate the clinical significance and screen the risk factors of redundant nerve roots(RNRs) in patients with lumbar spinal stenosis.
Methods The clinical data of 196 patients with lumbar spinal stenosis in the department of Spinal Surgery,Yijishan Hospital,Wannan Medical College from April 1,2015 to November 30,2020 were retrospectively analyzed. All patients were divided into RNRs positive group and RNRs negative group according to the presence of RNRs. The differences in general clinical data,imaging parameters,visual analogue scale(VAS),Oswestry disability index(ODI),and other indicators between the two groups were compared. The risk factors which are highly correlated with RNRs were screened by binary Logistic regression analysis.
Results There were 59 cases in the RNRs positive group,with an occurrence rate of 29.95% (59/137),and 137 cases in the RNRs negative group. The incidence rate of RNRs in 196 patients with lumbar spinal stenosis was 30.10% (59/196). VAS and ODI scores of patients in the two groups were statistically significant (P<0.05),and clinical symptoms of patients in the RNRs positive group were more severe than those in the RNRs negative group. There were significant differences in age,number of stenosis segments,average area of lumbar dural sac,area of the narrowest segment and the narrowest segment(P<0.05). Binary logistic regression analysis showed that the number of stenosis segments,the average median sagittal diameter of spinal canal,and the average area of dural sac in lumbar intervertebral space were correlated with the generation of RNRs (P<0.05). The regression coefficient of the number of stenosis segments was -1.115,the regression coefficient of the median sagittal diameter of the spinal canal was -1.707,and the regression coefficient of the mean dural sac area of the lumbar intervertebral space was 7.556.
Conclusion The clinical symptoms of patients with lumbar spinal stenosis accompanied by RNRs are more severe than those without them. The number of narrow segments,median sagittal diameter of the spinal canal,and the area of the lumbar intervertebral dural sac are the high-risk factors for RNRs,with the area of the lumbar intervertebral dural sac has the highest correlation. |
| KEYWORDS:Redundant nerve toot Spinal stenosis Risk factors Intervertebral dural sac |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 吴仲宣,肖良,赵泉来,刘晨,孙竑洲,耿寅,江雨剑.马尾冗余症在腰椎管狭窄症患者中的临床意义及相关危险因素分析[J].中国骨伤,2023,36(9):890~895 |
| 英文格式: | WU Zhong-xuan,XIAO Liang,ZHAO Quan-lai,LIU Chen,SUN Hong-zhou,GENG Yin,JIANG Yu-jian.Clinical significance and risk factors of redundant nerve root in patients with lumbar spinal stenosis[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(9):890~895 |
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