腰椎滑脱椎弓根螺钉内固定融合术后邻近节段椎间隙变化的相关研究  

Related study on adjacent segments intervertebral space change after spondylolishesis pedicle screw internal fixation and fusion operation

作　　者：贾鹏[1] 赵文国[2] 王勇贵 

机构地区：[1]武警后勤学院附属医院骨科,天津300162 [2]河北联合大学附属医院骨科,河北唐山063000 [3]开栾总医院急诊科,河北唐山063000

出　　处：《新乡医学院学报》2013年第8期632-634,共3页Journal of Xinxiang Medical University

摘　　要：目的探讨腰椎内固定融合术后邻近椎间隙高度的变化及其与螺钉角度的关系。方法回顾性分析31例行腰椎内固定融合术的腰椎滑脱患者的临床资料,观察术后固定融合区邻近椎间隙的变化;对是否"悬浮固定"对邻近椎间隙高度变化的影响及不同邻近节段椎间隙高度变化进行对比;分析邻近椎间隙高度变化与螺钉角度的关系。结果 L5～S1固定组其上方的L4/L5椎间隙术后1 a高度与术后即时比较虽有一定程度的降低,但差异无统计学意义(P>0.05);L4～L5固定组其上方的L3/L4椎间隙及下方的L5/S1椎间隙术后1 a高度与术后即时比较虽有一定程度的降低,但差异亦无统计学意义(P>0.05);L5～S1固定组其上方的L4/L5椎间隙高度变化与L4～L5固定组其上方的L3/L4椎间隙高度变化比较,差异无统计学意义(P>0.05);L4～L5固定后,固定融合区上方邻近椎间隙(L3/L4)高度变化与下方邻近椎间隙(L5/S1)高度变化比较,差异无统计学意义(P>0.05);螺钉角度<6°组与螺钉角度≥6°组比较,固定融合区上方邻近椎间隙高度变化差异无统计学意义(P>0.05);固定融合区上方椎间隙高度变化与螺钉角度呈正线性相关关系(r=0.373,P=0.039)。结论是否"悬浮固定"对固定融合区邻近节段椎间隙无影响,固定融合区上、下方邻近节段椎间隙变化无差异;螺钉角度的大小与固定融合区上方邻近节段椎间隙存在正相关关系,即螺钉角度越大,椎间隙变小越明显。Objective To observe the change of the height of the adjacent segments intervertebral space after internal fixation and fusion operation of lumbar vertebrae and the relation between the change of height of intervetebral space in the adjacent segments and the angle of the pedicle screw.Methods Thirty-one patients who had undergone an internal fixation and fusion operation of lumbar vertebrae were analyzed retrospectively.The change of adjacent segments intervertebral space in fixed fusion zone after operation was observed;whether ＂Suspensory fixation＂ or not having influence on the change of height of adjacent intervertebral space and different adjacent segment on the change of height of adjacent intervertebral space were compared.The relation between the change of the height of the adjacent intervertebral space and the angle of pedicle screw was analyzed.Results In the operating-group,the heights of L4/L5 in the upper of the L5-S1 fixed group after postoperative one year reduced slightly than those after postoperative moment,but the change had no statistical significance（P0.05）;the heights of L3/L4 in the upper of the L4-L5 fixed group after postoperative one year reduced slightly than those after postoperative moment,but the change also had no statistical significance（P0.05）;the changes between the L5-S1 fixed group and the L4-L5 fixed group had no obvious difference（P0.05）.In the L4-L5 fixed group,there had no obvious difference between the change of the height of the upper adjacent intervertebral space and the change of the height of the lower one in fixed fusion zone（P0.05）.When the operating-group was divided into two groups according to the angle of pedicle screw（6°or ≥6°）and compared them,the change of the height of the upper adjacent intervertebral space in fixed fusion zone had no obvious difference（P0.05）.But there was positive and correlative relation between changes of the height of the adjacent intervertebral space and the angle of pedicle screw in fixed fusion zone（

关 键 词：腰椎 内固定 融合 椎间隙 退行性变 

分 类 号：R681.5[医药卫生—骨科学]