破裂型腰椎间盘突出症转归预测因素的Logistic回归分析
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作者Author单位AddressE-Mail
俞鹏飞 YU Peng-fei 南京中医药大学, 江苏 苏州 210046  
刘锦涛 LIU Jin-tao 南京中医药大学附属苏州市中医医院, 江苏 苏州 215009  
马智佳 MA Zhi-jia 南京中医药大学附属苏州市中医医院, 江苏 苏州 215009  
钟鸣 ZHONG Ming 苏州大学附属瑞华医院  
李晓春 LI Xiao-chun 南京中医药大学附属苏州市中医医院, 江苏 苏州 215009  
姜宏 JIANG Hong 南京中医药大学附属苏州市中医医院, 江苏 苏州 215009 honghong751@126.com 
期刊信息:《中国骨伤》2018年,第31卷,第6期,第522-527页
DOI:10.3969/j.issn.1003-0034.2018.06.008
基金项目:
中文摘要:

目的:探讨破裂型腰椎间盘突出症经保守治疗后突出物的转归及预测因素。

方法:选取2009年6月至2016年6月期间,对苏州市中医医院骨伤科单纯接受保守治疗的147例破裂型腰椎间盘突出症患者进行临床疗效及MRI随访。采用多因素非条件Logistic回归分析(后退逐步回归法),分析患者性别(X1)、年龄(X2)、病程(X3)、突出率(X4)、Komori分型(X5)、MSU分型(X6)、Iwabuchi分型(X7)、Pfirrmann分级(X8)、相邻椎体Modic改变(X9)、椎管形态(X10)、马尾沉降征Schizas分型(X11)共11项二分类变量与突出物吸收率的关系。

结果:所有病例经随访,共发现64例突出物重吸收(吸收率≥30%),占43.5%。其中病程<1年(P=0.006)、MSU分型3型(P=0.001)、Iwabuchi分型1或5型(P=0.000)、马尾沉降征Schizas分型A型或B型(P=0.004)的患者最容易发生重吸收。回归方程Y=-10.363+1.916X3+1.446X4-1.445X5+2.070X6+4.679X7+1.125X9+1.023X10+2.223X11。而年龄、性别、Pfirrmann分级和椎管形态对突出物重吸收的影响无统计学意义。

结论:破裂型腰椎间盘突出症经非手术治疗后可出现突出物的重吸收现象,其中病程<1年、MSU分型3型、Iwabuchi分型1或5型、马尾沉降征Schizas分型A型或B型的患者最容易发生重吸收,可作为突出物转归预测的关键参考因素。
【关键词】椎间盘移位  腰椎  后纵韧带  预测
 
Logistic regression analysis on the outcome predictive factors of ruptured lumbar disc herniation
ABSTRACT  

Objective: To investigate the outcome predictive factors of ruptured lumbar disc herniation after conservative treatment.

Methods: From June 2009 to June 2016,147 patients with ruptured lumbar intervertebral disc herniation were treated with conservative treatment in the orthopedics department of Suzhou Traditional Chinese Medicine Hospital for clinical efficacy and MRI follow-up. Multivariate Logistic regression analysis(Stepwise regression method)was used to analyze the relationship between the 11 categorical variables and absorptivity of protrusions:sex(X1),age(X2),course of disease(X3),the rate of protrusion (X4),the Komori type (X5),the MSU type (X6),the Iwabuchi type (X7),the Pfirrmann grade (X8),the Modic change on adjacent vertebrae (X9),spinal canal morphology (X10),the Schizas types of cauda equina sedimentation sign(X11).

Results: A total of 64 cases of prominent reabsorption among all cases followed-up (absorption rate ≥ 30%),accounting for 43.5%. The reabsorption of protrusions is more likely to occur in patients with a duration of less than 1 year(P=0.006),MSU type 3 (P=0.001),Iwabuchi type 1 or 5 (P=0.000),the Schizas type of cauda equina sedimentation sign A or B(P=0.004). Regression equation Y=-10.363+1.916X3+1.446X4-1.445X5+2.070X6+4.679X7+1.125X9+1.023X10 + 2.223X11. Such factors as age,gender,Pfirrmann classification and spinal canal morphology had no significant effect on reabsorption of protrusions.

Conclusion: Ruptured lumbar disc herniation can be reabsorbed after nonoperative treatment. And the reabsorption of protrusions is more likely to occur in patients with a duration of less than 1 year,MSU type 3,Iwabuchi type 1 or 5,the Schizas type of cauda equina sedimentation sign A or B,which can be used as the key reference factors for predicting the outcome of the projections.
KEY WORDS  Intervertebral disc displacement  Lumbar vertebrae  Posterior longitudinal ligament  Prediction
 
引用本文,请按以下格式著录参考文献:
中文格式:俞鹏飞,刘锦涛,马智佳,钟鸣,李晓春,姜宏.破裂型腰椎间盘突出症转归预测因素的Logistic回归分析[J].中国骨伤,2018,31(6):522~527
英文格式:YU Peng-fei,LIU Jin-tao,MA Zhi-jia,ZHONG Ming,LI Xiao-chun,JIANG Hong.Logistic regression analysis on the outcome predictive factors of ruptured lumbar disc herniation[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(6):522~527
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