退变性腰椎管狭窄症的非药物保守治疗效果研究

目的 研究非药物保守治疗对退变性腰椎管狭窄症患者的近期疗效.方法 对2010年3月至2011年3月在骨关节科、康复医学科就诊并接受非药物保守治疗的21位退变性腰椎管狭窄症患者进行前瞻性研究.于治疗前、1、3个月时分别评定.主要结局指标:数字疼痛分级法、中文版Roland-Morris功能障碍调查表;次要结局指标:中文版SF-36健康调查量表、有效率.本文用SPSS13.0软件对数据进行统计学分析.用方差分析检验差异的显著性,q检验做两两比较.结果 治疗前、1、3个月时的主要结局指标( NRS、RMDQ)和次要结局指标(SF-36)的差异均有统计学意义.结论 非药物保守治疗有利于退变性腰椎管狭窄症患者近期改善腰部功能、减轻疼痛、提高生活质量,应在考虑手术治疗以前先予实施.

Study about outcomes of non-pharmacological conservative treatment for lumbar spinal stenosis

Objective To describe the short-term outcomes of a non-pharmacological conservative approach to patients with LSS.Methods This is a prospective consecutive case series with short-term follow-up of 21 consecutive patients who were diagnosed with LSS.Patients recruited from the outpatients of orthopaedic department and rehabilitation department in the Peking University People's Hospital from March 2010 to March 2011.Patients had baseline interviews with follow-up questionnaires in the end of the first and the third month.Main outcome measures:pain intensity was measured using the Numerical Rating Scale (NRS) and disability was measured using the Roland Morris Disability Questionnaire ( RMDQ),as well as the 36-item Short Form Health Surrey (SF-36) and efficacy assessment for evaluation.Results All of 21 eligible consenting patients initially enrolling completed the follow-up.Pain at worst,functional status,quality of life improved significantly in the end of the first month.These were considered to be clinically meaningful in the end of the third month.No patients went on to require surgery.No major complications of treatment were noted.Conclusions A non-pharmacological conservative treatment may be useful and safe in bringing about clinically meaningful improvement in pain and disability in patients with LSS.Before surgical management,a non-surgical approach should be taken into account at first.