退变性腰椎侧凸PLIF手术前后腰椎矢状面几何相关性分析

Analysis of the the sagittal plane geometry associativity of the degeneration lumbar scoliosis patients perioperatively PLIF

目的:探讨采用短节段PLIF(posterior lumbar inter-body fusion)手术方法治疗的退变性腰椎疾病合并腰椎侧凸患者手术前后腰椎矢状面几何相关性。方法:收集2004年9月至2007年8月57例经PLIF手术治疗的退变性腰椎疾病合并腰椎侧凸患者的影像学资料,观察手术前后腰椎前屈曲度(LL)、融合节段之上腰椎前屈曲度(LL above fusion)、融合节段之内腰椎前屈曲度(LL within fusion)、融合节段之下腰椎前屈曲度(LL belowfusion)、骶椎前倾角度(SS)等参数的变化及各参数之间的相关性。结果:全组病例术后平均随访40个月(24～60个月),LL、LL within fusion、LL below fusion、SS手术前后差异均有统计学意义(P<0.01),LLabove fusion手术前后差异无统计学意义(P>0.05);术前LLabove fusion、LLwithin fusion、SS及术后LLabove fusion、LLwithin fusion、SS与术后LL有显著的相关性(P<0.001)。随访期间腰椎矢状面序列矫正度数及椎间隙高度无丢失。结论:退变性腰椎侧凸PLIF手术前后腰椎矢状面各参数之间存在明显相关性,术前测量腰椎各相关参数将有利于术中腰椎矢状面曲度重建。

Objective：To analyze the sagittal plane geometry associativity before and after few-segments PLIF（posterior lumbar inter-body fusion） of patients′ with degeneration lumbar scoliosis disease.Methods：The iconography informations of the fifty-seven cases of degeneration lumbar disease combined with scoliosis who had experienced PLIF from September,2004 to August,2007 were analyzed.The variation and the associativity between the preoperative and postoperative of the parmeters which contain LL,LL above fusion,LL within fusion,LL below fusion,SS were summarized.Results：The average period of follow up was 24 months（24-60 months）.There were significant difference between the preoperative LL,LL within fusion,LL below fusion,SS and the postoperative LL,LL within fusion,LL below fusion,SS（P〈0.01）.There were no significant difference between the preoperative LL above fusion and the postoperative LL above fusion（P〉0.05）.There were significant associativity between preoperative LL above fusion,preoperative LL within fusion,preoperative SS,postoperative LL above fusion,postoperative LL within fusion,postoperative SS and postoperative LL（P〈0.001）.During the follow up,neither the corrected degree of the sagittal had decreased,nor the intervertebral space done.Conclusion：In case of degeneration lumbar disease combined with scoliosis,the patients（sagittal plane parameters postoperativly has significant associativity with perioperatively of the few-segments PLIF and measuring the lumbar parameters preoperativewill be helpful to reconstruction of the sagittal plane curvature.