摘要
[目的]观察分析腰椎间盘突出症后路椎间融合术后邻近节段退变的发生及其危险因素。[方法]回顾本院2012年收治的腰椎间盘突出症患者67例。34例融合,33例保守作为对照。入院、末次随访时评测MRI、X线片参数：近端椎间高度丢失、近端小关节退变。采用SPSS 19进行统计分析。[结果]平均随访（25±2.4）个月（18～28个月）。椎间高度组内对照差异均有统计学意义（P〈0.01）,高度丢失组间对照差异有统计学意义（t=-6.969,P=0.000）。小关节退变的组内对照差异均有统计学意义（P〈0.05）,末次随访时组间差异有统计学意义（P=0.001）,入院时组间差异无统计学意义（P〉0.05）。前凸角异常是邻近节段退变的独立危险因素（P=0.043）。[结论]腰椎邻近节段退变是自然病程,融合加速该病程。前凸角异常是退变的重要因素,予适当矫正。
[Objective] To observe the occurrence of adjacent segment degeneration（ ASD） after posterior lumbar interbody fusion（ PLIF） in patients suffered from lumbar disc herniation（ LDH） for the purpose of exploring the risk factors.[Methods] Sixty- seven patients suffered from LDH was treated in the Hospital in 2012. Thirty- four of them had surgery of PLIF,while the other 33 did not as control. All patients underwent MRI and X- ray examination at both time of admission and the last follow- up,measuring indexes including： loss of proximal disc height（ PIH）,degeneration of proximal facet joint（ PFJ）. SPSS- 19 was used for statistical analysis. [Results] The follow- up of an average of（ 25 ± 2. 4） months（ 18 ～ 28months） was made. There were significant differences of PIH in both groups after follow- up（ P 0. 01）. There was significant difference of loss of PIH between groups（ t =- 6. 969,P = 0. 000）. Degeneration of PFJ had statistical differences in both groups after follow- up（ P 0. 05）. There was statistical difference of degeneration of PFJ between groups at the last follow-up（ P = 0. 001）,but no on admission（ P 0. 05）. Abnormalities of lumbar lordosis（ LL） was independent risk factors of ASD（ P = 0. 043）. [Conclusion] ASD has its natural course,which is accelerated by PLIF. Abnormalities of LL takes part in the course as an important risk factor of ASD. It is recommended to give appropriate correction.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2015年第13期1179-1182,共4页
Orthopedic Journal of China
关键词
腰椎融合
邻近节段退变
腰椎前凸角
lumbar fusion
adjacent segment degeneration
lumbar lordosis
