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腰椎融合内固定术后邻近节段退变的影响因素 被引量:30

Factors affecting adjacent segment degeneration after rigid lumbar internal fixation
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摘要 目的分析腰椎融合内固定术后邻近节段退变的影响因素及手术的临床效果。方法回顾性分析2002年1月~2007年7月因腰椎间盘突出症、腰椎管狭窄症及腰椎滑脱症接受腰椎融合内固定手术治疗的患者。观察手术邻近节段退变的发生率,并分析术前邻近节段椎间盘退变与否、融合位置、融合范围、性别对邻近节段退变的影响。同时分析腰椎融合内固定术后的临床效果。结果符合标准的病例共147例,随访时间30±10个月(18~84个月),其中20例(13.6%)患者发生了邻近节段退变,而且都发生在头侧邻近节段。如果邻近节段椎间盘术前存在退变,则术后出现ASD的机率将会显著增加(χ2=6.272,P=0.012)。Logistic回归多因素分析表明术前邻近节段椎间盘存在退变是术后出现ASD的危险因素(P=0.046),而性别、年龄、融合位置及融合范围不是ASD发生的危险因素。结论如果邻近节段椎间盘术前存在退变,则术后邻近节段发生ASD的机率将显著增加。 Objective To analyze the factors affecting the occurrence of adjacent segment degeneration (ASD) after lumbar internal fixation. Methods The clinical data of 147 surgical patients with lumbar disc herniation, lumbar spinal stenosis and lumbar spodylolisthesis undergoing surgeries between January 2002 and July 2007 in our hospital were reviewed. The correlations of gender, range of fixation, position of fixation, and characteristic of the adjacent disc to the occurrence of ASD were analyzed. Results The patients were followed up for a mean of 30±10months (18-84 months). The incidence of ASD was 13.6% in these patients, occurring all at the cephalad adjacent segment. The presence of preoperative degeneration of the adjacent disc gave rise to increased risk of ASD following the surgery (χ2=6.272,P=0.012), and multivariate analysis indicated that preoperative adjacent disc degeneration was a risk factor for postoperative ASD (P=0.046), but gender, range of fusion and site of fusion were not the risk factors. Conclusion Presence of adjacent segment degeneration before the operation is associated with a significantly increased risk of postoperative ASD.
出处 《南方医科大学学报》 CAS CSCD 北大核心 2010年第5期1134-1137,共4页 Journal of Southern Medical University
关键词 腰椎 融合内固定 邻近节段退变 lumbar rigid internal fixation adjacent segment degeneration
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