Value of Lumbar MRI Parameters in the Evaluation of Postoperative Curative Effect on Patients with Lumbar Disc Herniation and Analysis of Risk Factors.

Danguo Chen,Shengquan He

doi:10.1155/2021/4514704

Abstract

Objective For exploring the value of magnetic resonance imaging (MRI) parameters in the evaluation of postoperative curative effect on patients with lumbar disc herniation (LDH) and analyzing risk factors. Methods Totally 60 patients confirmed with LDH in our hospital between Jan. 2018 and Jan. 2020 were enrolled into the observation group (Obs group) given transforaminal endoscopic discectomy (TED). In addition, 60 individuals with low back pain but no LDH over the same time span were enrolled into the control group (Con group). The two groups were given lumbar MRI, and the cross-sectional area differences of bilateral psoas major muscle (BPMM) and multifidus muscle of the patients before and after therapy were evaluated. The visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) scores of the two groups before and after therapy were compared, and the associations of the cross-sectional area differences of BPMM and multifidus muscle with efficacy, VAS score, and JOA score were analyzed. According to MacNab criteria, the clinical efficacy on the patients was evaluated, on which the patients were grouped. In addition, logistic regression analysis was performed for analyzing risk factors of clinical efficacy, and receiver operating characteristic (ROC) curves were drawn for analyzing the value of risk factors with differences in clinical efficacy evaluation. Results The Obs group presented larger cross-sectional area differences of BPMM and multifidus muscle than the Con group (both P < 0.05). At 6 months after surgery, the Obs group showed a superior rate of 83.33%. In this group, patients with a superior efficacy showed smaller cross-sectional area differences of BPMM and multifidus muscle before surgery and at 6 months after surgery and got lower VAS scores and higher JOA scores than those without a superior efficacy (all P < 0.05). According to Pearson's correlation analysis, the cross-sectional area differences of BPMM and multifidus muscle before surgery and at 6 months after surgery were positively associated with VAS score and negatively associated with JOA score (both P < 0.05). According to logistic regression analysis, the cross-sectional area differences of BPMM and multifidus muscle were risk factors impacting the patients' prognosis. ROC curve-based analysis revealed that the cross-sectional area differences could be adopted as evaluation indexes for clinical efficacy on patients. Conclusion The cross-sectional area differences of BPMM and multifidus muscle can serve as reference indexes for evaluating the postoperative efficacy on patients with LDH.

Highlights

Sciatica is one debilitating pain in the lower back, with a lifetime incidence of approximate 30% [1]
60 patients confirmed with Lumbar disc herniation (LDH) in our hospital between Jan. 2018 and Jan. 2020 were enrolled into the observation group (Obs group) given transforaminal endoscopic discectomy (TED), including 38 males and 22 females, with the average age of (50.1 ± 6.2) years
Lumbar disc degeneration triggers nucleus pulposus protrusion and annulus fibrosus rupture and the compression of nerve roots, resulting in LDH accompanied by a series of symptoms such as low back pain and numbness of the lower limbs [16]. e abovementioned factors are prone to induce protrusion or prolapse of nucleus pulposus under the impact of external forces, interfering with lumbosacral nerve root and triggering clinical symptoms including lumbago and leg pain

Summary

Introduction

Sciatica is one debilitating pain in the lower back, with a lifetime incidence of approximate 30% [1]. It is triggered by nerve root compression or stimulation [2]. Lumbar disc herniation (LDH) is believed as one primary cause of sciatica, which afflicts 1%–. According to prior research [4], LDH is implicated in the destruction of annulus fibrosus (AF), the compression of nucleus pulposus (NP), and the stimulation of nerve fibers. Timely surgical treatment for LDH patients with surgical indications is the key to control the progression of the disease [5, 6].

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Conclusion