Correlative Factors for the Efficacy of Surgical Treatment for Single Segment Degenerative Lumbar Spinal Disorders_West China Medical Journal

Authors：

 LiuJin ^1,2 ,  LiuHao ¹ , LiTao ¹ , GongQuan ¹ , ZengJiancheng ¹ , SongYueming ¹

1. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Orthopedic Surgery, the First People's Hospital of Chengdu, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LiuHao, Email: liuhao6304@163.com

Keywords：

Degenerative lumbar spinal disorders; Surgical treatment; Correlative factors; Logistic regression analysis

DOI：

10.7507/1002-0179.20160069

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the correlative factors for the efficacy of surgical treatment for single segment degenerative lumbar spinal disorders. Methods From October 2008 to November 2010, a prospective non-randomized controlled study was carried out on 179 patients who were diagnosed to have L_4-5 degenerative lumbar spinal disorders and underwent surgical treatment. Ninety-seven patients were included in our study, including 64 males and 33 females, aged between 21 and 86 years old, averaging 49.0. The follow up lasted for an average of 18.9 (12-27) months. The correlative factors including age, sex, body mass index, preoperative psychological state and degree of low back pain, surgical methods, combination with adjacent segment degeneration and recurrence state were analyzed. Single and multiple-factor Logistic regression analysis was used to determine the relationship between independent factors and surgical results of lumbar degenerative disease. Results At the last follow-up, Japanese Orthopaedic Association scores were improved to 22.40±3.18 with an improving rate of (68.5±15.7)% compared with the preoperative condition (7.61±3.09), and the difference was significant (t=-33.031, P<0.001). Univariate analysis showed that all factors were variables associated with the surgical results excluding sex and age (P<0.05). Multiple-factor logistic regression analysis showed that the preoperative psychological state, combination with adjacent segment degeneration and surgical methods had important impact on the surgical results (P<0.05). Conclusion Surgical treatment of lumbar degenerative disease is effective. The preoperative psychological state, combination with adjacent segment degeneration and surgical methods are important factors associated with the surgical results.

Citation： LiuJin, LiuHao, LiTao, GongQuan, ZengJiancheng, SongYueming. Correlative Factors for the Efficacy of Surgical Treatment for Single Segment Degenerative Lumbar Spinal Disorders. West China Medical Journal, 2016, 31(2): 253-257. doi: 10.7507/1002-0179.20160069 Copy

1.	Turner JA, Ersek M, Herron L, et al. Patient outcomes after lumbar spinal fusions[J]. JAMA 1992, 268(7):907-911.
2.	Yorimitsu E, Chiba K, Toyama Y, et al. Long-term outcomes of standard discectomy for lumbar disc herniation:a follow-up study of more than 10 years[J]. Spine, 2001, 26(6):652-657.
3.	Peul WC, Brand R, Thomeer RT, et al. Influence of gender and other prognostic factors on outcome of sciatica[J]. Pain, 2008, 138(1):180-191.
4.	Mariconda M, Zanforlino G, Celestino GA, et al. Factors influencing the outcome of degenerative lumbar spinal stenosis[J]. J Spinal Disord, 2000, 13(2):131-137.
5.	Li G, Patil CG, Lad SP, et al. Effects of age and comorbidities on complication rates and adverse outcomes after lumbar laminectomy in elderly patients[J]. Spine (Phila Pa 1976), 2008, 33(11):1250-1255.
6.	Patel N, Bagan B, Vadera S, et al. Obesity and spine surgery:relation to prioperative complications[J]. J Neurosurg spine, 2007, 6(4):291-297.
7.	Nygaard OP, Kloster R, Solberg T. Duration of leg pain as a predictor of outcome after surgery for lumbar disc herniation:a prospective cohort study with 1-year follow up[J]. J Neurosurg, 2000, 92(Suppl2):131-134.
8.	Yamashita K, Aono H, Yamasaki R. Clinical classification of patients with lumbar spinal stenosis based on their leg pain syndrome:its correlation with 2-year surgical outcome[J]. Spine (Phila Pa 1976), 2007, 32(9):980-985.
9.	George SZ, Coronado RA, Beneciuk JM, et al. Depressive symptoms, anatomica region, and clinical outcomes for patients seeking outpatient physical therapy for musculoskeletal pain[J]. Phys Ther, 2011, 91(3):358-372.
10.	LaCaille RA, DeBerard MS, Masters KS, et al. Presurgical biopsychosocial factors predict multidimensional patient:outcomes of interbody cage lumbar fusion[J]. Spine J, 2005, 5(1):71-78.
11.	Mattila VM, Saarni L, Parkkari J, et al. Early risk factors for lumbar discectomy:an 11-year follow-up of 57, 408 adolescents[J]. Eur Spine J, 2008, 17(10):1317-1323.
12.	Ekman P, Möller H, Hedlund R. Predictive factors for the outcome of fusion in adult isthmic spondylolisthesis[J]. Spine (Phila Pa 1976), 2009, 34(11):1204-1210.
13.	李宁秀, 刘朝杰, 李俊, 等.四川省城乡居民SF-36评价参考值[J]. 华西医科大学学报, 2001, 32(1):43-47.
14.	Ruetten S, Komp M, Merk H, et al. Recurrent lumbar disc herniation after conventional discectomy:a prospective, randomized study comparing full-endoscopic interlaminar and transforaminal versus microsurgical revision[J]. J Spinal Disord Tech, 2009, 22(2):122-129.
15.	郭炯炯, 唐天驷, 杨惠林, 等.开窗腰椎间盘切除再手术的远期疗效[J]. 中华外科杂志, 2005, 43(16):1075-1079.
16.	Genevay S, Atlas SJ. Lumbar spinal stenosis[J]. Best Pract Res Clin Rheumatol, 2010, 24(2):253-265.
17.	Kuchta J, Sobottke R, Eysel P, et al. Two-year results of interspinous spacer (X-Stop) implantation in 175 patients with neurologic intermittent claudication due to lumbar spinal stenosis[J]. Eur Spine J, 2009, 18(6):823-829.
18.	Adelt D. The interspinous U implant (now Coflex^TM) Long-term outcome, study overview and differential indication[J]. Orthopade, 2010, 39(6):595-601.
19.	刘进, 刘浩, 李涛, 等. 单节段 Coflex 棘突间动力重建与后路360°植骨融合治疗腰椎退变性疾病的对比研究[J]. 中国修复重建外科杂志, 2011, 25(6):693-698.
20.	孙浩林, 李淳德, 刘宪义, 等. 棘突间固定系统与融合固定系统联合应用治疗腰椎退变性疾患[J]. 中华外科杂志, 2010, 48(5):363-367.
21.	Padua R, Padua S, Romanini E, et al. Ten- to 15-year outcome of surgery for lumbar disc herniation:radiographic instability and clinical findings[J]. Eur Spine J, 1999, 8(1):70-74.
22.	Mariconda M, Galasso O, Attingenti P, et al. Frequency and clinical meaning of long-term degenerative changes after lumbar discectomy visualized on imaging tests[J]. Eur Spine J, 2010, 19(1):136-143.
23.	Harrop JS, Youssef JA, Maltenfort M, et al. Lumbar adjacent segment degeneration and disease after arthrodesis and total disc arthroplasty[J]. Spine (Phila Pa 1976), 2008, 33(15):1701-1707.

1. Turner JA, Ersek M, Herron L, et al. Patient outcomes after lumbar spinal fusions[J]. JAMA 1992, 268(7):907-911.
2. Yorimitsu E, Chiba K, Toyama Y, et al. Long-term outcomes of standard discectomy for lumbar disc herniation:a follow-up study of more than 10 years[J]. Spine, 2001, 26(6):652-657.
3. Peul WC, Brand R, Thomeer RT, et al. Influence of gender and other prognostic factors on outcome of sciatica[J]. Pain, 2008, 138(1):180-191.
4. Mariconda M, Zanforlino G, Celestino GA, et al. Factors influencing the outcome of degenerative lumbar spinal stenosis[J]. J Spinal Disord, 2000, 13(2):131-137.
5. Li G, Patil CG, Lad SP, et al. Effects of age and comorbidities on complication rates and adverse outcomes after lumbar laminectomy in elderly patients[J]. Spine (Phila Pa 1976), 2008, 33(11):1250-1255.
6. Patel N, Bagan B, Vadera S, et al. Obesity and spine surgery:relation to prioperative complications[J]. J Neurosurg spine, 2007, 6(4):291-297.
7. Nygaard OP, Kloster R, Solberg T. Duration of leg pain as a predictor of outcome after surgery for lumbar disc herniation:a prospective cohort study with 1-year follow up[J]. J Neurosurg, 2000, 92(Suppl2):131-134.
8. Yamashita K, Aono H, Yamasaki R. Clinical classification of patients with lumbar spinal stenosis based on their leg pain syndrome:its correlation with 2-year surgical outcome[J]. Spine (Phila Pa 1976), 2007, 32(9):980-985.
9. George SZ, Coronado RA, Beneciuk JM, et al. Depressive symptoms, anatomica region, and clinical outcomes for patients seeking outpatient physical therapy for musculoskeletal pain[J]. Phys Ther, 2011, 91(3):358-372.
10. LaCaille RA, DeBerard MS, Masters KS, et al. Presurgical biopsychosocial factors predict multidimensional patient:outcomes of interbody cage lumbar fusion[J]. Spine J, 2005, 5(1):71-78.
11. Mattila VM, Saarni L, Parkkari J, et al. Early risk factors for lumbar discectomy:an 11-year follow-up of 57, 408 adolescents[J]. Eur Spine J, 2008, 17(10):1317-1323.
12. Ekman P, Möller H, Hedlund R. Predictive factors for the outcome of fusion in adult isthmic spondylolisthesis[J]. Spine (Phila Pa 1976), 2009, 34(11):1204-1210.
13. 李宁秀, 刘朝杰, 李俊, 等.四川省城乡居民SF-36评价参考值[J]. 华西医科大学学报, 2001, 32(1):43-47.
14. Ruetten S, Komp M, Merk H, et al. Recurrent lumbar disc herniation after conventional discectomy:a prospective, randomized study comparing full-endoscopic interlaminar and transforaminal versus microsurgical revision[J]. J Spinal Disord Tech, 2009, 22(2):122-129.
15. 郭炯炯, 唐天驷, 杨惠林, 等.开窗腰椎间盘切除再手术的远期疗效[J]. 中华外科杂志, 2005, 43(16):1075-1079.
16. Genevay S, Atlas SJ. Lumbar spinal stenosis[J]. Best Pract Res Clin Rheumatol, 2010, 24(2):253-265.
17. Kuchta J, Sobottke R, Eysel P, et al. Two-year results of interspinous spacer (X-Stop) implantation in 175 patients with neurologic intermittent claudication due to lumbar spinal stenosis[J]. Eur Spine J, 2009, 18(6):823-829.
18. Adelt D. The interspinous U implant (now Coflex^TM) Long-term outcome, study overview and differential indication[J]. Orthopade, 2010, 39(6):595-601.
19. 刘进, 刘浩, 李涛, 等. 单节段 Coflex 棘突间动力重建与后路360°植骨融合治疗腰椎退变性疾病的对比研究[J]. 中国修复重建外科杂志, 2011, 25(6):693-698.
20. 孙浩林, 李淳德, 刘宪义, 等. 棘突间固定系统与融合固定系统联合应用治疗腰椎退变性疾患[J]. 中华外科杂志, 2010, 48(5):363-367.
21. Padua R, Padua S, Romanini E, et al. Ten- to 15-year outcome of surgery for lumbar disc herniation:radiographic instability and clinical findings[J]. Eur Spine J, 1999, 8(1):70-74.
22. Mariconda M, Galasso O, Attingenti P, et al. Frequency and clinical meaning of long-term degenerative changes after lumbar discectomy visualized on imaging tests[J]. Eur Spine J, 2010, 19(1):136-143.
23. Harrop JS, Youssef JA, Maltenfort M, et al. Lumbar adjacent segment degeneration and disease after arthrodesis and total disc arthroplasty[J]. Spine (Phila Pa 1976), 2008, 33(15):1701-1707.

Previous Article
结核性脑膜炎的诊治进展
Next Article
Anesthetic Procedure for Left Thoracic Sympathectomy under Thoracoscope in Long QT Syndrome Patients

West China Medical Journal

Correlative Factors for the Efficacy of Surgical Treatment for Single Segment Degenerative Lumbar Spinal Disorders

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content