| OBJECTIVE:To investigate whether peri-menopausal period is an independent risk factor for chronic low back pain complicated by postoperative lumbar degenerative disease。METHODS:From January 2014 to September 2016,female patients who diagnosed as lumbar disc herniation and degenerative lumbar canal stenosis,underwent discectomy,PLIF or TLIF surgery were included in our study.Risk factors for chronic low back pain including age,BMI,basic diseases,preoperative chronic low back pain,preoperative leg pain,VAS score of low back pain and leg pain,preoperative lumbar JOA score,operative method,number of surgery segment,surgery segment,operator,blood loss,peri-menopausal period and premenopausal syndrome were investigated in our study.All risk factors were analyzed with single factor logistic regression analysis,multiplicity logistic regression analysis and propensity score matching(PSM)respectively.Data were analyzed with SPSS 22.0.P<0.05 was found to be statistically significant.RESULT: Of 178 cases enrolled female patients,147(82.58%)cases were followed up successfully and 31 cases were lost,follow-up rate was 82.58%.The follow-up time ranged from 6 to 39 months,mean follow-up time was 19.14±9.33 months.The age ranged from 19 to 77 years old,the average age was49.68±11.76 years.There were 63 cases with peri-menopausal period(42.86%)and 33 patients with perimenopausal period syndrome(22.45%).53 cases underwent chronic low back pain(36.05%).The single factor Logistic analysis showed that the risk factors associated with chronic low back pain complicated by postoperative lumbar degenerative disease were BMI,preoperative chronic low back pain,operation time,bleeding loss,peri-menopausal and perimenopausal syndrome(p<0.05);The multivariate Logistic analysis showed that independent risk factors associated with chronic low back pain of lumbar degenerative disease surgery were preoperative chronic low back pain,perimenopausal and menopausal syndrome;The PSM analysis showed that there was statistically significant(p<0.05)between the study group(group of peri-menopausal period)and control group(group of non peri-menopausal period)in incidence of chronic low back pain;There was no statistically significant(p>0.05)between A group(patients with perimenopausal syndrome)and B group(patients without perimenopausal syndrome)in incidence of chronic low back pain.CONCLUSION:(1)For female patients,peri-menopausal is an independent risk factor for chronic low back pain complicated by postoperative lumbar degenerative disease.(2)For female patients,BMI,preoperative chronic low back pain,operation times,intra-operative blood loss and perimenopausal syndrome are risk factors for chronic low back pain complicated by postoperative lumbar degenerative disease. |
