背景:几名患者抱怨腰椎退行性疾病(LDD)的腰椎减压术后残留症状。然而,很少有研究通过关注术前患者的症状来分析这种不满。进行这项研究是为了通过关注患者的术前症状来确定可以预测患者术后投诉的因素。
方法:纳入了因LDD而接受腰椎减压和融合术的四十七例连续患者。在术后6、12、18和24个月的门诊随访期间,至少有两次相同的投诉定义为术后投诉。在投诉组(C组,N=168)和非投诉组(NC组,N=249)。人口统计,Operative,症状,通过单因素和多因素分析比较两组之间的临床因素。
结果:术前主要主诉为放射痛(318/417,76.2%)。然而,术后最常见的主诉是残余放射痛(60/168,35.7%),其次是刺痛感(43/168,25.6%)。精神疾病的存在(调整后的优势比[aOR],4.666;P=0.017),疼痛持续时间更长(aOR,1.021;P<0.001),疼痛到膝盖以下(aOR,2.326;P=0.001),术前刺痛感(aOR,2.631;P<0.001),术前感觉和运动功率降低(AOR,2.152和1.678;分别为P=0.047和0.011)与多变量分析中的术后患者投诉显着相关。
结论:通过检查患者的术前症状特征,可以提前预测和解释术后患者的主诉,包括持续时间和站点仔细。这可能有助于增强对术前手术结果的理解,可以控制病人的预期。
BACKGROUND: Several patients complained of residual symptoms following lumbar decompressive surgery for lumbar degenerative disease (LDD). However, few studies analyze this dissatisfaction by focusing on preoperative patients\' symptoms. This study was conduct to determine the factors that could predict the patients\' postoperative complaints by focusing on their preoperative symptoms.
METHODS: Four hundred and seventeen consecutive patients who underwent lumbar decompression and fusion surgery for LDD were included. Postoperative complaint was defined by at least twice same complaint during the outpatient follow-up of 6,12, 18 and 24 months after surgery. A comparative analysis was performed between complaint group (group C, N = 168) and non-complaint group (group NC, N = 249). Demographic, operative, symptomatic, and clinical factors were compared between the groups by univariate and multivariate analyses.
RESULTS: The main preoperative chief complaints were radiating pain (318/417, 76.2%). However, most common postoperative complaint was residual radiating pain (60/168, 35.7%) followed by tingling sensation (43/168, 25.6%). The presence of psychiatric disease (adjusted odds ratio [aOR], 4.666; P = 0.017), longer pain duration (aOR, 1.021; P < 0.001), pain to below the knee (aOR, 2.326; P = 0.001), preoperative tingling sensation (aOR, 2.631; P < 0.001), preoperative sensory and motor power decrease (aOR, 2.152 and 1.678; P = 0,047 and 0.011, respectively) were significantly correlated with postoperative patients\' complaints in multivariate analysis.
CONCLUSIONS: The postoperative patients\' complaints could be predicted and explained in advance by checking the preoperative characteristics of patients\' symptoms, including the duration and site carefully. This could be helpful to enhance the understanding of the surgical results preoperatively, which could control the anticipation of the patients.