Risk factors for postoperative numbness syndrome secondary to lumbar disc herniation based on propensity score matching
- VernacularTitle:基于倾向性评分匹配法探讨腰椎间盘突出症术后继发麻木综合征的危险因素
- Author:
Rongwei ZHONG
1
;
Jiayu CHEN
;
Zhanliang LIU
Author Information
- Keywords: lumbar disc herniation; numbness syndrome; risk factors; propensity score matching; nucleus pulposus removal
- From: Journal of Clinical Medicine in Practice 2024;28(21):105-110
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the risk factors for postoperative numbness syndrome sec-ondary to lumbar disc herniation(LDH)based on propensity score matching(PSM).Methods A retrospective analysis was conducted on the clinical data of 429 LDH patients who underwent surgical treatment.The patients were divided into numbness syndrome group(85 patients)and non-numbness syndrome group(344 patients)according to whether they developed postoperative numbness syn-drome.A 1∶1 match was performed between the numbness syndrome group and the non-numbness syndrome group based on PSM,with 67 patients in each group after matching.The clinical data of the two groups before and after matching were compared,and Cox regression analysis was performed on the matched data to screen risk factors for postoperative numbness syndrome secondary to LDH.Re-sults The incidence of postoperative numbness syndrome in LDH patients was 19.81％(85/429).Be-fore matching,the numbness syndrome group had a higher or longer proportion of males,age,body mass index(BMI),duration of disease,proportion of patients with L3 to L4 or L4 to L5 lesion segments,proportion of patients with grade Ⅳ to Ⅴ disc degeneration,proportion of patients with prolapsed or free-fragment herniation,operation time,proportion of patients with incomplete nucleus pulposus re-moval during surgery,proportion of patients with annulus fibrosus rupture,proportion of patients with a history of hyperlipidemia,proportion of patients who did not undergo postoperative rehabilita-tion exercises,and postoperative activity intensity scores compared to the non-numbness syndrome group(P＜0.05).After matching,the numbness syndrome group had higher or longer age,BMI,duration of disease,proportion of patients with grade Ⅳ to Ⅴ disc degeneration,proportion of pa-tients with prolapsed or free-fragment herniation,proportion of patients with incomplete nucleus pul-posus removal during surgery,proportion of patients with annulus fibrosus rupture,proportion of pa-tients with a history of diabetes,proportion of patients who did not undergo postoperative rehabilita-tion exercises,and postoperative activity intensity scores compared to the non-numbness syndrome group(P＜0.05).The results of multivariate Cox regression analysis showed that high BMI,gradeⅣ to Ⅴ disc degeneration,incomplete nucleus pulposus removal during surgery,annulus fibrosus rupture,history of diabetes,lack of postoperative rehabilitation exercises,and high postoperative activity intensity were independent risk factors for postoperative numbness syndrome secondary to LDH(HR=4.395,7.183,4.404,5.633,3.521,4.929,3.710,P＜0.05).Conclusion Af-ter controlling for confounding factors based on PSM,the risk factors for postoperative numbness syn-drome secondary to LDH include high BMI,grade Ⅳ to Ⅴ disc degeneration,incomplete nucleus pulposus removal during surgery,annulus fibrosus rupture,a history of diabetes,lack of postopera-tive rehabilitation exercises,and high postoperative activity intensity,which is helpful for clinical healthcare professionals to early identify high-risk patients with postoperative numbness syndrome secondary to LDH and provide a reference for subsequent patient treatment.
