Diagnosis,treatment and early outcome evaluation of radicular lumbar disease
10.16781/j.CN31-2187/R.20240302
- VernacularTitle:神经根型腰椎病的诊治及早期疗效评价
- Author:
Xiaowen LIU
1
;
Tianyi ZHAO
;
Lei LIU
;
Haoyang SHI
;
Yang HOU
;
Guodong SHI
Author Information
1. 海军军医大学(第二军医大学)第二附属医院脊柱外科,上海 200003
- Keywords:
radicular lumbar disease;
diagnostic criteria;
surgical treatment;
modified transforaminal lumbar interbody fusion;
nerve root tension
- From:
Academic Journal of Naval Medical University
2024;45(11):1439-1443
- CountryChina
- Language:Chinese
-
Abstract:
Objective To propose diagnostic criteria for radicular lumbar disease(RLD)and evaluate its surgical outcomes.Methods A retrospective study was conducted on 31 patients with RLD who were admitted to Department of Spinal Surgery of our hospital from Mar.2020 to Oct.2023.The nerve root tension during the operation was recorded,and the surgical complications,visual analog scale(VAS)score,Oswestry disability index(ODI),Japanese Orthopaedic Association(JOA)score,and modified MacNab score were statistically analyzed.Results There were 13 males and 18 females,with an average age of(56.39±9.96)years.All the patients underwent modified transforaminal lumbar interbody fusion(TLIF),including 2 cases of single-level operation,22 cases of two-level operation,4 cases of three-level operation,2 cases of four-level operation,and 1 case of six-level operation.The follow-up duration was(15.29±4.34)months.The nerve root tension during the operation was higher(25.00[22.00,28.25]g),while it decreased immediately after the operation(2.00[0.00,3.00]g),with significant differences(P＜0.01).The VAS score,ODI and JOA score after operation were improved compared with those before operation(all P＜0.01).At the last follow-up,there were 24 cases of"excellent",5 cases of"good",2 cases of"fair",and no"poor"in the modified MacNab score,and the excellent and good rate was 93.55%(29/31).Surgical complications(including cerebrospinal fluid leakage and incision infection)were occurred in 1 case each.Conclusion The remarkable clinical feature of patients with RLD is high tension of nerve.These patients can be treated by modified TLIF to improve the nerve hypertonia;early and accurate diagnosis and timely intervention are the keys to a good prognosis.
