Predictors of bad and good outcome of lumbar spine surgery - A prospective clinical study with 2 years' follow-up
Predictors of bad and good outcome of lumbar spine surgery - A prospective clinical study with 2 years' follow-up
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DOI：
10.1097/00007632-199605010-00013
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发表时间：
1996-05-01
期刊：
影响因子：
3
通讯作者：
Dvorak, J
中科院分区：
文献类型：
--
作者：
Junge, A;Frohlich, M;Dvorak, J
Study Design.通过前瞻性评估，对腰椎间盘手术患者进行检查以确定临床结果的可靠预测因素。 目的。在 2 年的随访中评估了先前研究中制定的筛查清单的预后价值。背景数据摘要。腰椎间盘手术的结果研究表明，其成功率在 49-90% 之间。已经表明，许多病史数据以及社会人口学和心理诊断结果对于腰椎手术的结果具有预后价值。方法。除了临床和神经放射学检查外，164 名患者还参加了标准化访谈。 82% 的人参加了术后 2 年进行的随访。比较了三个诊断亚组的术前发现、结果和预测。 83 名患者 (51%) 仅患有椎间盘突出症，29 名患者 (18%) 患有椎间盘突出症和其他相关背部诊断，51 名患者 (31%) 没有椎间盘突出症，但有其他相关背部诊断。结果。在仅患有椎间盘突出症的患者中，53% 的患者观察到良好的结果，19% 的患者观察到良好的结果，28% 的患者观察到不良的结果。术后结果预测的准确度对于预后良好的患者为75%，对于预后不良的患者为85%。在诊断为椎间盘突出以外的患者组中，手术成功率为 38%，良好，28%，中等，41%，不良，但预测评分不如其他组有用。结论。可以在术前识别出腰椎间盘切除术后手术结果不良的高风险患者。建议这些患者参加疼痛管理方法来代替手术干预或在手术干预的基础上进行补充。
Study Design. Eased on prospective assessment, patients with lumbar disc surgery were examined to determine reliable predictors for clinical outcome.Objectives. The prognostic value of a screening checklist developed in a previous study was evaluated in a 2-year follow-up.Summary of Background Data. Outcome studies of lumbar disc surgery document a success rate between 49-90%. It has been shown that a number of medical history data and sociodemographic and psychodiagnostic findings are of prognostic value for the outcome of lumbar spine surgery.Methods. In addition to clinical and neuroradiologic examinations, 164 patients took part in a standardized interview. Eighty-two percent participated in a follow-up performed 2 years after the operation. Preoperative findings, outcome, and prediction of three diagnostic subgroups were compared. Eighty-three (51%) patients had disc herniation only, 29 (18%) had disc herniation and other relevant back diagnoses, and 51 (31%) had no disc herniation but had other relevant back diagnoses.Results. In patients with disc herniation only, good results were observed in 53%, moderate in 19%, and bad in 28%. The accuracy of prediction of the postoperative result was 75% for the patients with good outcome and 85% for those with bad outcome. in the group of patients with diagnoses other than disc herniation, the success rate of the operation was 38% good, 28% moderate, and 41% bad, but the predictor score was not as useful as for the other groups.Conclusion. Patients with a high risk of a bad operation outcome after lumbar discectomy could be identified preoperatively. It is suggested that those patients take part in a pain management approach instead of or in addition to surgical intervention.