广东医学2025，Vol.46Issue(11)：1708-1713,6.DOI:10.13820/j.cnki.gdyx.20251224
Pfirrmann分级、腰部MRI参数及疼痛敏感评分预测LDH内镜手术短期疗效的价值
The value of Pfirrmann grading,lumbar MRI parameters,and pain sensitivity score in predicting the efficacy of LDH endoscopic surgery
摘要
Abstract
Objective The Pfirrmann grade,lumbar MRI parameters and pain sensitivity questionnaire(PSQ)scores of patients with lumbar disc herniation(LDH)were observed to investigate the value of their prediction of the effi-cacy of endoscopic surgery for LDH.Methods A total of 122 patients with LDH who were treated in our hospital from January 2022 to March 2024 were selected as the research subjects.All patients underwent endoscopic surgery.The pa-tients were followed up for 12 months.According to the Oswestry Disability Index efficacy evaluation criteria,the patients were divided into the effective group(n=109)and the ineffective group(n=13).The Pfirrmann grades,lumbar MRI parameters and PSQ scores of the two groups of patients were compared,and their predictive value for surgical efficacy was analyzed.Results The Pfirrmann grading ratio,△ lumbar muscle cross-sectional area,△ lumbar multifidus cross-sectional area,and PSQ score of the ineffective group were all higher than those of the effective group(P＜0.05).The results of logistic regression analysis showed that Pfirrmann grading,△ lumbar muscle cross-sectional area,△ lumbar multifidus muscle cross-sectional area,and PSQ score were all independent risk factors for poor postoperative efficacy in LDH patients(P＜0.05),and were positively correlated with them.According to ROC curve analysis,the cross-sec-tional area of the erector spinae muscle,the cross-sectional area of the lumbar multifidus muscle,PSQ score,and com-bined diagnosis all have high predictive value for the postoperative efficacy of LDH patients,with AUC values of 0.869,0.890,0.797,and 0.984,respectively.Pfirrmann grading can be used as an auxiliary indicator to predict the postopera-tive efficacy of LDH patients,with an AUC value of 0.721.Conclusion The Pfirrmann grading,△ lumbar muscle cross-sectional area,△ lumbar multifidus cross-sectional area,and PSQ score are closely related to the efficacy of endoscop-ic surgery in LDH patients.The combination of these four factors has a high predictive power for the postoperative efficacy of LDH patients.关键词
腰椎间盘突出症/Pfirrmann分级/磁共振成像/疼痛敏感/疗效Key words
lumbar disc herniation/Pfirrmann classification/magnetic resonance imaging/pain sensitivity ques-tionnaire/curative effect分类
医药卫生引用本文复制引用
李洪伟,赵鹏飞,柴旭斌,周英杰..Pfirrmann分级、腰部MRI参数及疼痛敏感评分预测LDH内镜手术短期疗效的价值[J].广东医学,2025,46(11):1708-1713,6.基金项目
河南省中医药科学研究专项课题(2024ZYZD10) （2024ZYZD10）
