老年患者腰椎融合术对发生邻近节段退行性变的影响  

The effect of lumbar fusion surgery on the incidence of adjacent segment degeneration among elderly patients

作　　者：王秀军[1] 褚建国[1] 

机构地区：[1]唐山工人医院骨科,河北唐山063000

出　　处：《现代预防医学》2013年第22期4289-4291,共3页Modern Preventive Medicine

摘　　要：目的研究老年患者腰椎融合术对邻近节段退行性变(adjacent segment disease,ASD)发生的影响。方法286例已经进行腰椎融合手术的患者按照融合节段的数目分为3组,研究其邻近节段的退行性变的发生情况。并且统计邻近节段退行性变和年龄、性别、融合节段的数目以及部位的影响。结果 55岁以上腰椎融合术后的患者发生ASD21例,发病率23.9%,55岁以下患者发生25例,发病率12.7%,55岁以上发生ASD明显高于55以下患者,差异有统计学意义(P﹤0.05);55岁以上男性患者发生ASD7例,女性发生ASD14例,女性明显高于男性,差异有统计学意义(P﹤0.05);A组患者中发生ASD的患者合计10例,B组患者中发生ASD的患者合计18例,C组患者中发生ASD的患者合计18例,差异有统计学意义(P﹤0.05)。结论老年腰椎融合术后患者更容易发生ASD,尤其是老年女性比老年男性更容易发生ASD;ASD的发生和融合节段的多少成正变关系,并且ASD更容易发生于融合节段的上端。OBJECTIVE The study aimed to investigate the effect of lumbar fusion surgery on the incidence of adjacent seg- ment degeneration （ASD） among elderly patients. METHODS 286 patients received a lumbar fusion surgery were divided into 3 groups according to the number of segments fused during the surgery, and the incidence of ASD among the patients were studied. The correlation between ASD and age, gender, and the number and site of fused segments of the patients were analyzed. RESULTS 21 cases of ASD （23.9%） occurred among the lumbar fusion patients over the age of 55, and 25 ASD cases （ 12.7% ） was observed among the patients under the age of 55 ; the incidence of ASD was significantly higher among patients older than 55 than among those younger than 55 （P 〈 0.05）. Among the patients over 55, ASD occurred in 7 male and 14 female patients, indicating that the incidence of ASD among women was significantly higher than that among men （P 〈 0.05）. 10, 18, and 18 cases of ASD were observed among patients in the A, B, and C groups, respectively; the differ- ence was statistically significant （P 〈 0.05）. CONCLUSION ASD tends to occur in elderly patients who have received a lum- bar fusion surgery, and elderly women is more susceptible to ASD than elderly men. The incidence of ASD is positively cor- related with the number of fused segments, and ASD is more likely to occur on the upper end of the fused segments.

关 键 词：腰椎 脊柱融合术 邻近节段退行性变 

分 类 号：R687.43[医药卫生—骨科学]