A 5 year follow-up study on non-surgical treatment of ruptured lumbar disc herniation / 中国骨伤
China Journal of Orthopaedics and Traumatology
; (12): 414-419, 2020.
Article
ي Zh
| WPRIM
| ID: wpr-828280
المكتبة المسؤولة:
WPRO
ABSTRACT
OBJECTIVE@#To investigate the short-term and mid-term efficacy with non-surgical treatment and to predict the long-term outcomes of ruptured lumbar disc herniation.@*METHODS@#From February 2011 to February 2014, 75 patients with single-segment ruptured lumbar disc herniation treated by non-surgical therapy were selected for prospective study. There were 53 males and 22 females, aged from 18 to 58 (35.62±9.96) years old. The course of disease was from 5 days to 6 months, with an average of (46.45±40.66) days. The lesions were located at L in 4 cases, at L in 29 cases, at LS in 42 cases. Radiation pain in 46 cases on the left and 29 cases on the right. The JOA score, straight leg raising test angle and finger-to-ground distance were assessed pretreatment and at 3 months, 6 months, 1 year, 2 years and 5 years after treatment. The improvement rate of JOA at the final follow up (5 years after treatment) was calculated and the curative effect according to JOA score was evaluated;the volume change of protrusion before treatment and at the final follow-up (5 years after treatment) was analyzed, the volume absorption rate of protrusion was calculated and the absorption of protrusion was observed;the relationship between the improvement rate of JOA and the absorption rate of protrusion were analyzed.@*RESULTS@#Seventy one patients were finally followed up at 5 years after non surgical treatment. The JOA score, straight leg raising test angle and finger to ground distance at 3 months, 6 months, 1 year, 2 years and 5 years after treatment were significantly improved (0.05). There was significant differencein other time points (<0.05). The results of the straight leg raising test angle and the finger-to-ground distance were similar to the JOA scores. The improvement rate of JOA score was (62.69± 2.47)% at the final follow-up. According to JOA score, the results were excellent in 26 cases, good in 26 cases, fair in 14 cases, poor in 5 cases, and the excellent and good rate was 73.24%. The volume of protrusion decreased from (1 981.73±588.72) mm to (1 011.82±395.47) mm3, the total absorption rate was (45.65±2.83)%, the protrusion was obviously absorbed in 24 cases, partially absorbed in 26 cases, not absorbed in 19 cases, and increased in 2 cases. It was found that there was a positive correlation between improvement rate of JOA scores and protrusion absorption rate at 5 years after non surgical treatment (r= 0.679, <0.001).@*CONCLUSION@#Non-surgical treatment of ruptured lumbar disc herniation can achieve good results, clear the characteristics of the ruptured lumbar disc herniation and prognosis, and some patients have "reabsorption" phenomenon.
Key words
النص الكامل:
1
الفهرس:
WPRIM
الموضوع الرئيسي:
Prospective Studies
/
Follow-Up Studies
/
Treatment Outcome
/
Intervertebral Disc Degeneration
/
Intervertebral Disc Displacement
/
Lumbar Vertebrae
نوع الدراسة:
Observational_studies
/
Prognostic_studies
المحددات:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
اللغة:
Zh
مجلة:
China Journal of Orthopaedics and Traumatology
السنة:
2020
نوع:
Article