[1]姜文涛,梅伟,王庆德,等.腰椎融合术后邻近节段退变的影响因素分析[J].中医正骨,2017,29(03):3-5.
　JIANG Wentao,MEI Wei,WANG Qingde,et al.Analysis of factors influencing adjacent segment degeneration after lumbar spinal fusion[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(03):3-5.
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腰椎融合术后邻近节段退变的影响因素分析()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期数:
2017年03期
页码:
3-5
栏目:
临床研究
出版日期:
2017-03-20

文章信息/Info

Title:
Analysis of factors influencing adjacent segment degeneration after lumbar spinal fusion
作者:
姜文涛; 梅伟; 王庆德;  郭润栋; 李格
河南省郑州市骨科医院,河南 郑州 450052
Author(s):
JIANG Wentao; MEI Wei; WANG Qingde; GUO Rundong; LI Ge
Zhengzhou Orthopaedic Hospital,Zhengzhou 450052,Henan,China
关键词:
腰椎;  脊柱融合术;  手术后并发症;  邻近节段退变;  影响因素分析
Keywords:
lumbar vertebrae;  spinal fusion;  postoperative complications;  adjacent segment degeneration;  root cause analysis
摘要:
目的:分析腰椎融合术后邻近节段退变的影响因素。方法:收集2010年1月至2014年6月因腰椎间盘突出症、腰椎管狭窄症、腰椎滑脱在郑州市骨科医院行后路腰椎间融合术患者的治疗和随访资料,包括性别、年龄、术前邻近节段退变情况、融合节段、术后邻近节段退变情况。结果:共收集到146例患者的资料,术后所有患者腰腿痛症状均明显缓解。所有患者均获得随访,随访时间18～37 个月,中位数28个月。随访期间2例患者发生断钉,3 例患者出现椎间植骨吸收,其余141例患者椎间植骨均融合。141例术后椎间植骨融合的患者中,男性患者腰椎融合术后邻近节段退变的发生率(17/79)与女性(14/62)相比,差异无统计学意义(χ2=0.023,P=0.880); 年龄≥60岁的患者腰椎融合术后邻近节段退变的发生率(27/89)高于年龄<60岁的患者(4/52),差异有统计学意义(χ2=9.813,P=0.000); 术前存在邻近节段退变的患者,腰椎融合术后邻近节段退变的发生率(22/67)高于术前不存在邻近节段退变的患者(9/74),差异有统计学意义(χ2=8.762,P=0.000); 多节段融合的患者术后邻近节段退变的发生率(21/54)高于单节段融合的患者(10/87),差异有统计学意义(χ2=14.578,P=0.000)。结论:年龄大、术前存在邻近节段退变、多节段腰椎融合,是术后发生邻近节段退变的风险因素。
Abstract:
ABSTRACT Objective:To analyze the factors influencing adjacent segment degeneration(ASD)after lumbar spinal fusion.Methods:The medical records of patients with lumbar disc herniation,lumbar spinal stenosis or lumbar spondylolisthesis who were treated with lumbar spinal fusion through posterior approach from January 2010 to June 2014 in Zhengzhou Orthopaedic Hospital were collected.The collected clinical data consisted of gender,age,preoperative ASD,fused segments and postoperative ASD.Results:The clinical data of 146 patients were collected and the medical records showed that the lumbocrural pain were relieved obviously in all patients after surgery.All patients were followed up for 18-37 months with a median of 28 months.The breakage of nail(1 case)and intervertebral bone-graft absorption(3 cases)were found during the follow-up period.One hundred and forty-one patients obtained intervertebral bone graft fusion.There was no statistical differences in the incidence rate of ASD between males(17/79)and females(14/62)after surgery of intervertebral fusion with bone graft(χ2=0.023,P=0.880).The incidence rate of postoperative ASD was higher in patients≥60 years old(27/89)compared to patients<60 years old(4/52)(χ2=9.813,P=0.000).The incidence rate of postoperative ASD was higher in patients with preoperative ASD(22/67)compared to patients without preoperative ASD(9/74)(χ2=8.762,P=0.000).The incidence rate of postoperative ASD was higher in patients with multiple-segment intervertebral fusion(21/54)compared to patients with single-segment intervertebral fusion(10/87)(χ2=14.578,P=0.000).Conclusion:Old age,preoperative ASD and multiple-segment lumbar intervertebral fusion are the risk factors for postoperative ASD.

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通讯作者:梅伟 E-mail:meiwei9606@163.com
更新日期/Last Update: 1900-01-01