Clinical typing and treatment strategies of lumbar degenerative diseases
10.16781/j.CN31-2187/R.20240406
- VernacularTitle:腰椎退变性疾病的临床分型研究及治疗策略分析
- Author:
Yang HOU
1
;
Tianyi ZHAO
;
Xiaowen LIU
Author Information
1. 海军军医大学(第二军医大学)第二附属医院骨科,上海 200003
- Keywords:
lumbar degenerative diseases;
clinical typing;
radicular lumbar diseases;
treatment strategies;
treatment outcomes
- From:
Academic Journal of Naval Medical University
2025;46(6):743-750
- CountryChina
- Language:Chinese
-
Abstract:
Objective To propose a clinical typing method for lumbar degenerative disease(LDD),including the diagnostic criteria for each type and the corresponding surgical treatment strategies.Methods A total of 245 LDD patients who were admitted to Department of Orthopaedics,The Second Affiliated Hospital of Naval Medical University from Jun.2017 to May 2022 were enrolled and assigned to nerve root type(42 cases),disc herniation type(73 cases),spinal stenosis type(61 cases),spondylolisthesis type(29 cases),and local type(40 cases)according to our diagnostic criteria of clinical typing.Treatment outcomes of various groups were compared and the reliability of the typing method was assessed using consistency test.Results A total of 205 cases received surgical treatment and 40 cases received non-surgical treatment.The surgical approach was modified transforaminal lumbar interbody fusion.The patients were followed up for(20.37±6.13)months.According to Nakai's evaluation criteria,the clinical effect was excellent in 146(59.59％)cases,good in 89(36.33％)cases,fair in 8(3.27％)cases,and poor in 2(0.82％)cases,with an excellent and good rate of 95.92％.There were no significant differences in the treatment effects among different types of LDD(P＞0.05).The results of clinical consistency evaluation confirmed that the typing method had good consistency both within observers and between observers.Conclusion This clinical typing method can help to further understand the pathogenesis of LDD,improve the accuracy of diagnosis and optimize the treatment plan.
