单节段后路椎间融合内固定术对腰椎前凸角度变化的影响

Effects of single level posterior lumbar interbody fusion on angle changes of lumbar lordosis

目的探讨L4/L5单节段后路椎间融合器置入椎弓根内固定术对患者腰椎前凸角度变化的影响。方法回顾性随访分析43例L4/L5单节段后路椎间融合器置入配合使用椎弓根内固定术的患者,对患者术前、术后总腰椎前凸角度、L4/L5节段前凸角、骶骨倾斜角进行比较。结果 L4/L5单节段后路椎间融合术后患者总腰椎前凸角度与术前对比平均增加8.4°(P<0.01);L4/L5节段前凸角与术前对比平均增加3.5°(P<0.05);骶骨倾斜角与术前对比平均增加4.2°(P<0.05)。结论 L4/L5单节段后路椎间融合器置入椎弓根内固定术可以明显改善患者腰椎前凸角度,对于改善腰椎序列和缓解患者术后腰痛症状以及延缓邻近节段退变均有积极意义。

Objective To investigate the effect of posterior lumbar interbody fusion（PLIF） of the L4/L5 single segment on angle change of lumbar lordosis.Methods The clinical data of 43 patients who underwent PLIF of the L4/L5 single segment were retrospectively analyzed.The angle of lumbar lordosis,the endplate angle of L4/L5,and the sacral inclination angle of the patients were compared before and after operation.Results The lumbar lordosis angle increased by 5°-15°（an average of 8.4 °） after PLIF of the L4/L5 single segment（P〈0.01）;the endplate angle of L4/L5 increased by 1°-7°（an average of 3.5 °,P〈0.05）;and the sacral inclination angle increased by an average of 4.2°（P〈0.05）.Conclusion PLIF of L4/L5 single segment can significantly increase the lumbar lordosis angle and improve the lumbar alignment,and can help to relieve the low back pain symptoms and delay the degeneration of the adjacent segments.