To Explore The Effect Of Metabolic Syndrome On The Clinical Manifestations And Treatment Of Lumbar Disc Herniation

Objective To investigate the effect of Metabolic Syndxome(Met S)on the clinical manifestations(lumbar pain,depressive state,and lumbar function)and treatment methods(surgical treatment or conservative treatment)in patients with lumbar disc herniation(LDH).Methods Collect data on patients with single-segment LDH at lumbar4/lumbar 5(L4/L5)or lumbar 5/1(L5/S1)hospitalized at the Spinal Surgery Department of Xiangtan Central Hospital from September 2015 to December2017.Eliminate lumbar spondylolisthesis,trauma,surgical history,infection,tumor,congenital malformations,spinal stenosis,serious cardiovascular and cerebrovascular diseases,liver and kidney function diseases,or other diseases that affect patients' physiological functions.Compliance and poor comprehension cannot be studied.Smooth communication and other patients.The study subjects' sex,age,height,weight,duration,blood pressure,blood glucose,blood lipids,lumbar MRI examination results,Visual Analogue Scale(VAS),Hamilton Depression(Hamilton Depression)Scale,HAMD),Japanese Orthopaedic Association Scores(JOA),surgical or other clinical data were entered into the study questionnaire.According to lumbar MRI results,the lumbar intervertebral discs were divided into four types: bulging type,prominent type,prolapsed type,and free type.Combined with or without Met S,each type was divided into LDH combined with Met S group(LDHM group)and LDH alone.The group(LDH group)compared the pain level,depression status,lumbar function,and treatment methods between the two groups.Finally,multivariate analysis was performed on the factors that affect the degree of lumbar and leg pain,depression,and lumbar functionResults 1?259 patients with LDH were included in the inclusion and exclusion criteria,of which L4/5 was 136 patients and L5/S1 was 123 patients.There were 56 cases of lumbar intervertebral disc bulging type,prominent type,prolapse type,and free type(11 cases in LDHM group,45 cases in LDH group),89 cases(21 cases in LDHM group,68 cases in LDH group),and 90cases(LDHM group 53 cases).Cases,37 cases of LDH group)and 24 cases(15 cases of LDHM group and 9 cases of LDH group).2? In the bulging disc type,prominent type,and prolapsed type,the VAS(waist),VAS(leg)pain score,and the HAMD depression score of the LDHM group were higher than those of the LDH group(P<0.05).The JOA lumbar spine function score was lower In the LDH alone group(P<0.05),in the disc free type,there was no significant difference in the VAS(waist),VAS(leg)pain scores,the HAMD depression scores,JOA lumbar spine function scores between the LDHM group and the LDH group(P).>0.05).3?The proportion of patients who underwent surgical treatment in the intervertebral disc herniation type,prolapsed type,and free type LDHM group was higher than that in the LDH group(P<0.05).In the intervertebral disc bulging type,both groups were treated conservatively.4 ? Met S is the degree of lumbar and leg pain in patients with LDH(P=0.000,OR=6.121,95%CI=2.343 to 15.981),depression status(P<0.001,OR=4.552,95%CI=2.457 to 8.429),lumbar function(P=0.002,OR=3.098,95% CI=1.541 to 6.241)Independently related factors.Conclusions Met S is an independent correlative factor affecting lumbar and leg pain,depressive state and lumbar function in patients with LDH.It can aggravate the degree of lumbar and leg pain and depression in patients with LDH to a certain extent,reduce lumbar function,and increase the bulging typeType of surgical intervention rate.