腰椎间盘突出症患者单边双通道内镜治疗的预后影响因素分析

Analysis of prognostic factors in patients with lumbar disc herniation after UBE spine surgery

摘要:

目的 分析腰椎间盘突出症（LDH）患者单边双通道内镜（UBE）治疗的预后影响因素。方法 选取2020年5月—2022年9月在延边大学附属医院行UBE治疗的LDH患者100例，术后随访6个月，根据MacNab标准评价预后，将预后优、良患者纳入优良组（70例），可、差患者纳入可差组（30例）。比较优良组与可差组患者临床资料差异；采用多因素逐步Logistic回归分析LDH患者UBE治疗的预后影响因素。结果 多因素逐步Logistic回归分析结果显示，年龄> 45岁［O^R=3.479（95% CI：1.615，7.493）］、重或极重强度体力劳动［O^R=3.966（95% CI：1.851，8.499）］、病程≥ 1年［O^R=4.700（95% CI：2.465，8.963）］、临床表现腰痛兼腿痛［O^R=3.417（95% CI：1.131，10.322）］、责任节段多节段［O^R=1.800（95% CI：1.162，2.789）］是LDH患者UBE治疗后预后不佳的危险因素（P <0.05）。结论 年龄、体力劳动强度、病程、临床表现及责任节段是LDH患者UBE治疗的预后影响因素。

Abstract:

Objective To analyze the factors affecting the prognosis of patients with lumbar disc herniation (LDH) after unilateral biportal endoscopic (UBE) spine surgery.Methods One hundred patients with LDH who underwent UBE spine surgery in our hospital from May 2020 to September 2022 were selected. They were followed up for 6 months after surgery, and evaluated according to the MacNab criteria. The patients with good and excellent prognosis were included in the good and excellent group (70 cases), and those with fair and poor prognosis were included in the fair and poor group (30 cases). The differences in clinical data between the good and excellent group and the fair and poor group were compared. Multivariable stepwise Logistic regression analysis was performed to determine the factors affecting the prognosis of LDH patients after UBE spine surgery.Results Multivariate stepwise Logistic regression analysis showed that age > 45 years [O^R = 3.479 (95% CI: 1.615, 7.493) ], heavy or extremely heavy physical work [O^R = 3.966 (95% CI: 1.851, 8.499) ], disease course ≥1 year [O^R = 4.700 (95% CI: 2.465, 8.963) ], presence of low back pain and leg pain [O^R = 3.417 (95% CI: 1.131, 10.322) ], and multi-segment involvement [O^R = 1.800 (95% CI: 1.162, 2.789) ] were all risk factors for poor prognosis of LDH patients after UBE spine surgery (P < 0.05).Conclusions Age, intensity of physical work, disease course, clinical manifestation and the segment involved are all factors affecting the prognosis of LDH patients after UBE spine surgery.