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[1]姜文濤,梅偉,王慶德,等.腰椎融合術(shù)后鄰近節(jié)段退變的影響因素分析[J].中醫(yī)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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腰椎融合術(shù)后鄰近節(jié)段退變的影響因素分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期數(shù):
2017年03期
頁碼:
3-5
欄目:
臨床研究
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:
姜文濤; 梅偉; 王慶德;  郭潤棟; 李格
河南省鄭州市骨科醫(yī)院,河南 鄭州 450052
Author(s):
JIANG Wentao; MEI Wei; WANG Qingde; GUO Rundong; LI Ge
Zhengzhou Orthopaedic Hospital,Zhengzhou 450052,Henan,China
關(guān)鍵詞:
腰椎;  脊柱融合術(shù);  手術(shù)后并發(fā)癥;  鄰近節(jié)段退變;  影響因素分析
Keywords:
lumbar vertebrae;  spinal fusion;  postoperative complications;  adjacent segment degeneration;  root cause analysis
摘要:
目的:分析腰椎融合術(shù)后鄰近節(jié)段退變的影響因素。方法:收集2010年1月至2014年6月因腰椎間盤突出癥、腰椎管狹窄癥、腰椎滑脫在鄭州市骨科醫(yī)院行后路腰椎間融合術(shù)患者的治療和隨訪資料,包括性別、年齡、術(shù)前鄰近節(jié)段退變情況、融合節(jié)段、術(shù)后鄰近節(jié)段退變情況。結(jié)果:共收集到146例患者的資料,術(shù)后所有患者腰腿痛癥狀均明顯緩解。所有患者均獲得隨訪,隨訪時(shí)間18～37 個(gè)月,中位數(shù)28個(gè)月。隨訪期間2例患者發(fā)生斷釘,3 例患者出現(xiàn)椎間植骨吸收,其余141例患者椎間植骨均融合。141例術(shù)后椎間植骨融合的患者中,男性患者腰椎融合術(shù)后鄰近節(jié)段退變的發(fā)生率(17/79)與女性(14/62)相比,差異無統(tǒng)計(jì)學(xué)意義(χ2=0.023,P=0.880); 年齡≥60歲的患者腰椎融合術(shù)后鄰近節(jié)段退變的發(fā)生率(27/89)高于年齡<60歲的患者(4/52),差異有統(tǒng)計(jì)學(xué)意義(χ2=9.813,P=0.000); 術(shù)前存在鄰近節(jié)段退變的患者,腰椎融合術(shù)后鄰近節(jié)段退變的發(fā)生率(22/67)高于術(shù)前不存在鄰近節(jié)段退變的患者(9/74),差異有統(tǒng)計(jì)學(xué)意義(χ2=8.762,P=0.000); 多節(jié)段融合的患者術(shù)后鄰近節(jié)段退變的發(fā)生率(21/54)高于單節(jié)段融合的患者(10/87),差異有統(tǒng)計(jì)學(xué)意義(χ2=14.578,P=0.000)。結(jié)論:年齡大、術(shù)前存在鄰近節(jié)段退變、多節(jié)段腰椎融合,是術(shù)后發(fā)生鄰近節(jié)段退變的風(fēng)險(xiǎn)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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通訊作者:梅偉 E-mail:[email protected]
更新日期/Last Update: 1900-01-01