足部敲击测试作为腰骶神经根病运动功能的简单量化指标

IF 2.6 2区 医学 Q2 CLINICAL NEUROLOGY Spine Pub Date : 2025-01-01 Epub Date: 2024-06-11 DOI:10.1097/BRS.0000000000005063
Hiroshi Kobayashi, Takuya Nikaido, Koji Otani, Kazuyuki Watanabe, Kinshi Kato, Yoshihiro Kobayashi, Michiyuki Hakozaki, Takuya Kameda, Yoichi Kaneuchi, Miho Sekiguchi, Shoji Yabuki, Shin-Ichi Konno, Yoshihiro Matsumoto
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引用次数: 0

摘要

研究设计:我们对接受手术治疗的腰骶椎根病患者的数据进行了回顾性分析:目的:评估敲脚试验(FTT)在评估腰骶椎根病患者手术前后下肢运动功能方面的有效性:腰骶神经根病在老龄人口中越来越常见。尽管采用了标准治疗方法,但瘫痪往往导致术后恢复不完全,因此有必要及早发现并进行干预:我们招募了 2009 年至 2020 年期间在本院接受腰骶椎根病手术的患者。有腰椎手术史、透析史、类风湿性关节炎史和椎体过渡史的患者被排除在外。FTT 评分的测量方法是在脚跟与地面保持接触的情况下,让脚底尽可能多地敲击地面 10 秒钟。L4、L5和S1组采用根性病变一侧的得分进行分配,对照组采用完好一侧的得分进行分配。数据分析采用邓尼特检验进行组间比较,采用配对 t 检验进行术前术后比较:结果:在 522 名符合条件的患者中,有 80 名(159 名神经根患者,1 名半假肢患者)接受了分析。L4 和 L5 组患者术前的 FTT 评分明显低于对照组,这表明患者存在功能障碍。术后一年,各组的 FTT 评分均有改善,其中 L5 组与对照组相比有明显改善;考虑到瘫痪和疼痛影响的敏感性分析结果也证实了这一点:结论:FTT 是早期发现腰骶神经根病变患者下肢运动功能障碍的重要工具,尤其是 L5 神经根受损患者,它有助于及时进行手术干预,并可改善术后效果和生活质量。
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Foot Tapping Test as a Simple Quantitative Index of Motor Function for Lumbosacral Radiculopathy.

Study design: We conducted a retrospective review of data from patients who underwent surgical treatment for lumbosacral radiculopathy.

Objective: To assess the effectiveness of the foot tapping test (FTT) in evaluating lower limb motor function in patients with lumbosacral radiculopathy pre and postsurgery.

Background: Lumbosacral radiculopathy is becoming increasingly common in aging populations. Despite standard treatments, paralysis often leads to incomplete postoperative recovery, necessitating early detection and interventions.

Patients and methods: We enrolled individuals who underwent surgery for lumbosacral radiculopathy at our facility between 2009 and 2020. Patients with a history of lumbar surgeries, dialysis, rheumatoid arthritis, and transitional vertebrae were excluded. The FTT score was measured by having the sole of the foot tap as many times as possible for 10 seconds while keeping the heel in contact with the floor. The L4, L5, and S1 groups were assigned using the scores on the side of the radiculopathy, and the control group was assigned using the scores on the intact side. Data were analyzed using the Dunnett test for group comparisons and paired t -tests for pre and postsurgery comparisons.

Results: Of the 522 eligible patients, 80 (159 nerve roots, 1 patient with hemi-prosthetic leg) were analyzed. The preoperative FTT scores in the L4 and L5 groups were significantly lower than those in the control group, indicating functional impairment. One year postsurgery, all groups showed improvements in FTT scores, with the L5 group exhibiting significant improvements compared with the control; this was supported by the results of sensitivity analyses considering the effects of paralysis and pain.

Conclusion: The FTT is a valuable tool for the early detection of lower limb motor dysfunction in lumbosacral radiculopathy, particularly for L5 nerve root impairment, where it aids in timely surgical intervention and may improve postoperative outcomes and quality of life.

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来源期刊
Spine
Spine 医学-临床神经学
CiteScore
5.90
自引率
6.70%
发文量
361
审稿时长
6.0 months
期刊介绍: Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store. Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
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