腰椎后路融合术后邻近节段退变的研究现状

Research Status of Adjacent Segment Degeneration After Dosterior Lumbar Fusion

邻近节段退变(adjacent segment degeneration,ASD)是腰椎后路融合术后常见并发症,其发生与自然衰老过程和临椎生物力学改变相关。高龄、女性、肥胖、骨质疏松等与ASD呈正相关。内植物的不合理应用、术中缺乏对临椎小关节保护、减压范围过大等医源性因素均增加了ASD的潜在风险。临床医生在充分掌握ASD发病机制及危险因素的基础之上,全面评估疾病的严重程度,合理的选择治疗方案,从而降低ASD的发病率,减轻患者精神及经济负担,提高患者的生活质量。

Adjacent segment degeneration(ASD) is a common complication after lumbar fusion. The pathogenic mechanisms of ASD include the progress of natural aging and the change of bio-mechanical mechanism, and its risk factors include advanced age, female, obesity, osteoporosis, etc. Iatrogenic factors such as irrational usage of internal fixation,lack of protection of facet joints and over-decompression during operation all increase the potential risk of ASD. On the basis of fully understanding the pathogenesis and risk factors of adjacent segmental degeneration, clinicians should comprehensively assess the severity of the disease and select reasonable treatment options, to reduce the incidence of ASD, improve the quality of life and lighten their mental and economic burden.