Abstract：Objective To investigate the clinical efficacy of conservative and surgical treatment of Schizas grades B and C patients with degenerative lumbar spinal stenosis based on magnetic resonance imaging (MRI) as well as the clinical value of Schizas morphological grading.Methods The clinical data of 62 patients with degenerative lumbar spinal stenosis were retrospectively analyzed in the First Affiliated Hospital of Xinjiang Medical University from January 2014 to December 2015. There were 33 males and 29 females with an age of 43-74 years. Of 39 patients with grade B, 20 patients underwent conservative treatment, and 19 received surgical treatment; in 23 patients with grade C, conservative treatment was carried on 13 patients, and surgical treatment was operated on 10 patients. The differences of Oswestry disability index(ODI), Japanese Orthopaedic Association(JOA) scores and visual analogue score(VAS) before treatment and at the last follow-up, as well as the hospitalization time and the cost during treatment were analyzed respectively in all patients. There was no significant difference in general data in the patients undergoing conservative and surgical treatment (all P values>0.05).Results All the patients were followed up for an average of 12 months ranging from 9 to 16 months. At the last follow-up, the ODI score was 10.88%±2.84% and 11.44%±2.80% respectively, the JOA score was 22.41±2.26 and 22.36±2.25 respectively as well as the VAS was 0.84±0.52 and 0.93±0.41 respectively in the grade B patients who received conservative and surgical treatment, and there was no significant difference between the two groups (t=-0.622, 0.065, -0.646; all P values>0.05), but significant difference in ODI, JOA scores and VAS was approached when compared with the counterpart values before treatment (all P values<0.05). In addition, there was significant difference between the two groups in hospitalization time and the cost (Z=-3.530, -5.339, all P values<0.05). At the last follow-up, the ODI was 16.72%±4.04% and 10.10%±1.63% respectively, the JOA score was 17.92±2.43 and 22.75±2.99 respectively as well as the VAS was 1.60±0.82 and 0.70±0.25 respectively in the grade C patients undergoing conservative and surgical treatment, and there was significant difference between the two groups (t=4.856, -4.271, 3.713; all P values<0.05); meanwhile there was also significant difference in ODI, JOA scores and VAS when compared with the counterpart data before treatment (all P values<0.05). There was no significant difference in hospitalization time (Z=-1.853, P>0.05), but there was significant difference in hospitalization cost between patients with conservative and surgical treatment (Z=-4.032, P<0.05).Conclusions Regular conservative and surgical treatment can improve the symptoms of patients with lumbar spinal stenosis to some degree. Therefore, Schizas morphological grading has a reference value in the treatment of lumbar spinal stenosis.
张树文, 李忠伟, 金格勒, 陆帅, 徐小雄. MRI Schizas形态学分型对腰椎管狭窄症疗效的评价[J]. 中华解剖与临床杂志, 2018, 23(1): 52-58.
Zhang Shuwen, Li Zhongwei, Jin Gele, Lu Shuai, Xu Xiaoxiong. Evaluation of Schizas morphological grading of lumbar spinal stenosis by magnetic resonance imaging. Chinese Journal of Anatomy and Clinics, 2018, 23(1): 52-58.
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2018, Vol. 23 
