融合器高度对腰椎椎间融合术后结局影响的研究进展

Research progress of effect of cage height on outcomes of lumbar interbody fusion surgery

目的 总结融合器高度对腰椎椎间融合术后结局的影响,明确融合器高度选择的重要性。方法 查阅近年来相关文献,对椎间融合器过高、过低相关并发症及融合器高度选择方法进行总结。结果 融合器高度不合适可能导致终板损伤、融合器沉降、内固定失效、邻近节段退变、过撑痛、间接减压不充分、手术节段稳定性下降、手术节段融合不佳、脊柱序列恢复不佳及术后融合器移位等问题。目前,腰椎椎间融合术中可靠的融合器高度选择方法是术中试模,但其准确性依赖于术者经验且难以标准化。结论 腰椎融合器高度选择不当将对患者预后产生不利影响,通过筛选影响融合器高度选择的因素来构建选择标准具有重要意义。

Objective To summarize the effect of cage height on outcomes of lumbar interbody fusion surgery and the importance of the cage height selection.Methods The related literature was widely reviewed to summarize the research progress on the complications caused by inappropriate height of the cage and the methods of selecting cage height.Results Inappropriate height of the cage can lead to endplate injury,cage subsidence,internal fixation failure,adjacent segmental degeneration,over-distraction related pain,insufficient indirect decompression,instability of operation segment,poor interbody fusion,poor sequence of spine,and cage displacement.At present,the selection of the cage height is based on the results of the intraoperative model test,which is reliable but high requirements for surgical experience and hard to standardize.Conclusion The inappropriate height of the cage may have an adverse impact on the postoperative outcome of patients.It is important to develop a selection standard of the cage height by screening the related influential factors.