Value of Lumbar MRI Parameters in the Evaluation of Postoperative Curative Effect on Patients with Lumbar Disc Herniation and Analysis of Risk Factors

Abstract

Objective: For exploring the value of magnetic resonance imaging (MRI) parameters in the evaluation of postoperative curative effect on patients with lumbar disc herniation (LDH) and analyzing risk factors.

Methods: Totally 60 patients confirmed with LDH in our hospital between Jan. 2018 and Jan. 2020 were enrolled into the observation group (Obs group) given transforaminal endoscopic discectomy (TED). In addition, 60 individuals with low back pain but no LDH over the same time span were enrolled into the control group (Con group). The two groups were given lumbar MRI, and the cross-sectional area differences of bilateral psoas major muscle (BPMM) and multifidus muscle of the patients before and after therapy were evaluated. The visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) scores of the two groups before and after therapy were compared, and the associations of the cross-sectional area differences of BPMM and multifidus muscle with efficacy, VAS score, and JOA score were analyzed. According to MacNab criteria, the clinical efficacy on the patients was evaluated, on which the patients were grouped. In addition, logistic regression analysis was performed for analyzing risk factors of clinical efficacy, and receiver operating characteristic (ROC) curves were drawn for analyzing the value of risk factors with differences in clinical efficacy evaluation.

Results: The Obs group presented larger cross-sectional area differences of BPMM and multifidus muscle than the Con group (both P < 0.05). At 6 months after surgery, the Obs group showed a superior rate of 83.33%. In this group, patients with a superior efficacy showed smaller cross-sectional area differences of BPMM and multifidus muscle before surgery and at 6 months after surgery and got lower VAS scores and higher JOA scores than those without a superior efficacy (all P < 0.05). According to Pearson's correlation analysis, the cross-sectional area differences of BPMM and multifidus muscle before surgery and at 6 months after surgery were positively associated with VAS score and negatively associated with JOA score (both P < 0.05). According to logistic regression analysis, the cross-sectional area differences of BPMM and multifidus muscle were risk factors impacting the patients' prognosis. ROC curve-based analysis revealed that the cross-sectional area differences could be adopted as evaluation indexes for clinical efficacy on patients.

Conclusion: The cross-sectional area differences of BPMM and multifidus muscle can serve as reference indexes for evaluating the postoperative efficacy on patients with LDH.