摘要
目的分析腰椎融合术后邻近节段退变(ASD)患者再手术治疗效果。方法回顾性分析2015年1月至2020年1月郑州市骨科医院脊柱骨科Ⅱ收治的18例因腰椎融合术后ASD再手术治疗患者的临床资料,其中男11例,女7例,年龄25~67岁,平均(42.3±6.4)岁。所有病例均存在ASD的影像学表现及临床症状。患者经(15.1±1.3)个月的正规保守治疗无效。共随访6~25个月,平均(16.3±3.5)个月。观察再手术效果,比较再手术前与末次随访时患者视觉模拟评分(VAS)和日本骨科协会(JOA)腰椎评分。结果手术时间为(112±13)min,出血量为(267±57)mL。术后影像学检查显示椎体序列良好,无内固定物松动或断裂情况,椎间植骨均已骨性融合。再手术前及末次随访时,患者VAS评分分别为(6.1±1.2)、(2.6±0.9)分,JOA评分分别为(12.6±2.1)、(25.3±2.6)分。VAS评分较前降低(P<0.05),JOA评分较前提高(P<0.05)。结论再次手术为腰椎融合术后ASD的主要治疗方案,术后疗效令人满意。
Objective To analyze the effect of reoperation for patients with adjacent segment degeneration(ASD)after lumbar fusion.Methods The clinical data of 18 patients who underwent reoperation at the DepartmentⅡof Spine Orthopedics in Zhengzhou Orthopedic Hospital from January 2015 to January 2020 due to ASD after lumbar fusion were retrospectively analyzed.Among them,there were 11 males and 7 females,aged from 25 to 67 years old,with an average of(42.3±6.4)years old.The imaging manifestations and clinical symptoms of ASD were present in all cases.An average of(15.1±1.3)months of formal conservative treatment was ineffective.The follow-up period was 6-25 months,with an average of(16.3±3.5)months.Observe the effect of reoperation.The visual analogue scale(VAS)score and the lumbar spine score of the Japanese Orthopaedic Association(JOA)were compared before the reoperation and at the last follow-up.Results The operation time was(112±13)min.The bleeding volume was(267±57)mL.The postoperative imaging examination showed that the vertebral body sequence was good,there was no loosening or fracture of the internal fixation,and the intervertebral bone grafts had been bone fusion.Before reoperation and at the last follow-up,the VAS scores were(6.1±1.2)and(2.6±0.9)points,and JOA scores were(12.6±2.1)and(25.3±2.6)points,respectively.The VAS score was lower than before(P<0.05),and the JOA score was higher than before(P<0.05).Conclusion Reoperation is the main treatment plan for ASD after lumbar fusion,and the surgical effect is satisfactory.
作者
郭亮兵
潘玉林
郭小伟
李宝田
张猛
GUO Liangbing;PAN Yulin;GUO Xiaowei;LI Baotian;ZHANG Meng(DepartmentⅡof Spine Orthopedics,Zhengzhou Orthopedic Hospital,Zhengzhou 450052,China)
出处
《河南医学研究》
CAS
2021年第31期5787-5789,共3页
Henan Medical Research
关键词
腰椎融合术
邻近节段退变
再手术
疗效
lumbar fusion
adjacent segment degeneration
reoperation
curative effect
