The analysis of prognostic factors for postoperative patients with foot drop caused by lumbar degenerative disease
10.3969/j.issn.1004-406X.2017.10.07
- VernacularTitle:手术治疗腰椎退行性疾患所致足下垂的预后影响因素分析
- Author:
Yunfei LIN
1
;
Chunde LI
Author Information
1. 北京大学第一医院骨科 100034北京市
- Keywords:
Foot drop;
Lumbar degenerative disease;
Prognosis factors;
Cox regression analysis
- From:
Chinese Journal of Spine and Spinal Cord
2017;27(10):903-907
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To analyze the clinical result and the prognostic factors for postoperative patients with foot drop caused by lumbar degenerative disease.Methods:2341 patients who suffered from lumbar degenerative disease and underwent lumbar surgery from January 2011 to January 2016 were reviewed,among which 125 cases suffered from foot drop and caused by lumbar spinal stenosis(LSS) or lumbar disc herniation (LDH).Among the 125 patients,108 cases were enrolled with complete follow-up.All patients underwent modified PLIF and nerve roots decompression.The mean follow-up period was 2.4±1.5 years(range,1.4-5.2 years).Patients whose tibialis anterior(TA) muscle strength recovered to grade 4 or grade 5,the ankle could move freely,with a relative normal gait,could be considered as recovery.The following indexes were included in the single factor analysis by Log-rank test:age,gender,type of lumbar degeneration,duration of palsy,preoperative tibialis anterior strength,physical sensation disorder of affected lower limbs,number of affected limbs,preoperative VAS score,cauda equine syndrome,affected levels and history of trauma.Cox regression analysis was used to analyze the prognostic factors of surgical treatment effect.Results:Among 108 cases of patients with foot drop,59 cases were cured,the recovery rate was about 54.6％.Among them,44 cases were LSS,and 15 cases were cured,the rate was 34.1％;64 cases were LDH,44 cases were cured,the rate was 68.7％.The single factor analysis showed that age,type of lumbar degeneration,duration of palsy,preoperative TA muscle strength and number of affected limbs had significant relation with prognosis (P＜0.05).The Cox regression analysis showed the following indexes were the prognostic factors of foot drop:age,type of lumbar degeneration,duration of palsy and preoperative TA muscle strength(P＜0.05).Conclusions:Age,type of degeneration,duration of palsy and preoperative TA muscle strength are significantly related to the prognosis of foot drop caused by lumbar degenerative disease.Patiets with younger age,shorter duration,stronger TA muscle strength recover better;compared with LSS,foot drop caused by LDH recover better.
