摘要
背景:肥胖可使脊柱尤其是腰椎退化,随着肥胖发病率的增加,肥胖患者发生腰椎外科的手术日益增多,有关的研究表明,肥胖可能增加腰椎融合的并发症,尤其是伤口感染。目的:分析肥胖是否改变接受腰椎融合患者并发症的概率。方法:纳入行腰椎单节段融合的患者(包括正常体质量和肥胖患者)268例为样本,将腰椎融合了分为两种类型:前路腰椎融合和后路腰椎融合,用切除自体的髂前上棘的松质骨行椎间植骨,美敦力枢法模的钛棒固定,探查硬膜前方无碎骨屑后移,切口放置引流,逐层关闭。腰椎融合后预防感染对症治疗,分别就患者的不同并发症方面的数据进行统计学分析。结果与结论:268例中104名为肥胖患者。肥胖患者的并发症包括有心脏、肾、肺、伤口并发症等,以伤口并发症和肺部并发症为主,与正常体质量患者比较,差异均有显著性意义(P<0.05),但前后路方式之间并发症发生率比较,差异无显著性意义(P>0.05)。说明肥胖增加了腰椎融合手术并发症的风险,但在前后路腰椎不同融合方法中对患者的影响差别不大。
BACKGROUND： Morbid obesity can result in lumbar and spinal degeneration, especially the lumbar spine degeneration. Related studies have shown that morbid obesity may increase complications of the lumbar fusion, especially wound infection. OBJECTIVE： To analyze whether morbid obesity can alter the rates of complications in patients undergoing lumbar fusion. METHODS： 268 patients （including normal weight patients and morbid obese patients） undergoing lumbar single segment fusion were selected as samples. The lumbar and spinal fusion was divided into two types： anterior lumbar fusion and posterior lumbar fusion, The cancellous bone with autologous anterior superior lilac spine was treated with intervertebral bone grafting, and fixed with Medtronic Sofamor titanium rod. The detection found thatthere was no bone fragments crumbs backward in the anterior dura mater, then the drainage was placed in the incision and closed layer by layer. Symptomatic treatment was performed to prevent infection alter lumbar fusion, and the data of the different complications were statistically analyzed. RESULTS AND CONCLUSION： Among total 268 patients, 104 patients were morbidly obese. The complications of morbidly obese patients included cardiac, renal, pulmonary and wound complications, among them, wound and pulmonary complications were the main complications. There were significant differences in the complications between normal weight patients and morbidly obese patients （P 〈 0.05）. There were no significant differences in the rates of complications between anterior lumbar fusion and posterior lumbar fusion （P 〉 0.05）. Morbid obesity increases the risk of complications in lumbar and spinal fusion surgery, but has no different effects between the patients with anterior lumbar fusion and posterior lumbar fusion.
出处
《中国组织工程研究》
CAS
CSCD
2013年第22期4055-4061,共7页
Chinese Journal of Tissue Engineering Research
基金
江苏省自然科学基金资助项目(BK2012608)~~
关键词
骨关节植入物
脊柱植入物
肥胖
腰椎融合
腰椎退化
椎间植骨
钛合金
内固定
前路腰椎融合
后路腰椎融合
体质量指数
并发症
省级基金
bone and joint implants
spinal implants
morbid obesity
lumbar spinal fusion
lumbar degeneration intervertebral bone grafting
titanium alloy
internal fixation
anterior lumbar fusion
posterior lumbar fusion
body mass index
complications
provincial grants-supported paper
