24. ĐẶC ĐIỂM LÂM SÀNG VÀ CHẨN ĐOÁN HÌNH ẢNH Ở BỆNH NHÂN PHẪU THUẬT TLIF 3 TẦNG

Abstract

Objective: Describe the clinical characteristics and imaging diagnosis of patients with multilevel lumbar spinal stenosis due to degeneration, undergoing spinal fixation surgery, and posterior 3-level interbody bone grafting.

Subjects and methods: Study of 30 patients with multilevel lumbar spinal stenosis due to degeneration, undergoing spinal fixation surgery, and posterior 3-level interbody bone grafting at Bach Mai Hospital from June 2020 to June 2023 with complete medical records and research data, agreeing to participate in the study.

Results: All patients had symptoms of neurogenic claudication, 63.4% less than 100m. Half of the patients had severe back pain. In the legs, patients had only moderate (43.3%) or mild (56.7%) pain. All patients were positive for the Lasègue test. The rate of Lasègue below 30 degrees was 36.7% and Lasègue 30-70 degrees was 60%. 1/30 patients had movement disorders and 24/30 had sensory disorders in the form of paresthesia. The average ODI score for spinal dysfunction was 34.0 ± 4.8 (25 – 47). On X-ray, 70% of patients had spondylolisthesis. On MRI, spinal stenosis in the L34L45L5S1 region accounted for 96.7%.

Conclusion: The clinical and imaging symptoms of patients with multilevel lumbar spinal stenosis due to degeneration are quite typical with symptoms of back and leg pain; claudication, decreased life function and decreased patellar tendon and Achilles tendon reflexes, spondylolisthesis on X-ray (70%) and spinal stenosis in the L3L4L5S1 region (96.7%).