To Explore The Formation Factors Of Nerve Root Sedimentation Sign In Lumbar Disc Herniation And Its Relationship With The Efficacy Of Non-surgical Treatment

Objective :To explore the formation factors of nerve root sedimentation sign in lumbar disc herniation and the relationship between nerve root sedimentation sign and the effect of non-surgical treatment in lumbar disc herniation.Methods : From May 2017 to November 2018,67 patients with L4/5 lumbar disc herniation admitted to the Department of Rehabilitation Medicine,First Affiliated Hospital of Anhui Medical University were selected as subjects.According to the nerve root sedimentation sign,they were divided into positive group(33 cases)and negative group(34 cases).The age,sex,effective sagittal diameter of vertebral canal and index of disc herniation were compared between the two groups,and the difference of general data between the two groups was observed.The VAS score and ODI score of the two groups before non-surgical treatment were compared,and the difference between the two groups was compared.One month after non-surgical treatment,the difference of VAS score and ODI score between the two groups was observed.The lumbar spine MRI was reexamined in the positive group,and the changes of nerve root sedimentation before and after non-surgical treatment were compared in the positive group.Results:There was no significant difference in sex and age between the two groups(P > 0.05).There was significant difference in the effective sagittal diameter of the intervertebral canal between the two groups(t = 5.065,P < 0.05).The effective sagittal diameter of the intervertebral canal in the positive group was smaller than that in the negative group.There was significant difference in the index of disc herniation betweenthe two groups(t = 3.393,P < 0.05),and the index of disc herniation in the positive group was higher than that in negative group.There was no significant difference in VAS score and ODI score between the two groups before treatment(P > 0.05).There was significant difference in VAS score between the two groups after treatment(t =2.024,P < 0.05).The VAS score of positive patients was higher than that of negative patients.There was significant difference in ODI score between the two groups after treatment(t = 4.571,P < 0.05).ODI score of positive patients was higher than that of negative patients after treatment(t = 4.571,P < 0.05).The positive group was reexamined by MRI after non-surgical treatment,and the results showed that the nerve root sedimentation sign did not change.Conclusion: 1.There was no significant difference in sex and age between the positive group and the negative group of nerve root sedimentation sign.2.In LDH patients,the more obvious the herniation of intervertebral disc,the more severe the dural sac compression,the higher the positive rate of nerve root sedimentation sign.In LDH patients,the formation of nerve root sedimentation sign may be related to the inflammatory reaction caused by nucleus pulposus protrusion.;3.There is no significant difference in clinical symptoms between the positive and negative groups before non-operative treatment.The treatment effect of the positive group is worse than that of the negative group after non-operative treatment.Therefore,the nerve root sedimentation sign can be used as an index to predict the effect of non-operative treatment on LDH.