椎间植骨融合内固定术对腰椎疾患邻近椎间关节退变的影响  

Influence of interbody fusion intervertebral fixation on adjacent joint degeneration in patients with lumbar diseases

作　　者：黄占柱 仇小华[1] 张淑兰[2] 陈为国[1] 郭颖[1] 

机构地区：[1]河北省玉田县医院骨科,064100 [2]河北省玉田县医院重症医学科,064100

出　　处：《中国基层医药》2014年第15期2294-2296,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨椎间植骨融合内固定术对腰椎疾患邻近椎间关节退变的影响。方法以采用椎间植骨融合内固定术治疗的腰椎疾患患者56例作为研究对象，随访患者术后邻近椎间关节的退变情况。结果56例患者均获门诊随访，随访时间24～72个月，平均（41．2±8．3）个月。其中出现新的临床症状有12例（21．4％），其中8例为下腰痛、3例为下肢痛、1例为腰腿痛；出现影像学改变9例（16．1％），9例患者均伴有新的临床症状，其中5例为骨赘形成或加重，2例为邻近节段不稳（椎体I度滑脱），1例为小关节增生所致阶段性椎管狭窄，1例为椎间盘突出。在9例有影像学表现的患者中，内固定上位邻近节段发生退变7例，内固定下位邻近节段发生退变2例。结论腰椎疾患行椎间植骨融合内固定术后邻近椎间关节易于发生退变，手术中应减少破坏邻近关节。Objective To explore the influence of interbody fusion intervertebral fixation on adjacent joint degeneration in patients with lumbar diseases .Methods 56 patients with lumbar diseases who were taken interbody fusion intervertebral fixation were selected as the research subjects ,and the adjacent intervertebral joint degeneration in patients were followed up .Results 56 patients were followed up for 24-72 months,the average time was （41.2 ± 8.3）months.The new clinical symptoms were occurred in 12 cases（21.4%）,including 8 cases of low back pain, 3 patients with leg pain,1 case of lumbocrural pain.Radiographic changes occurred in 9 cases（16.1%）,9 cases of patients with new clinical symptoms ,including 5 cases of osteophyte formation or exacerbation ,2 cases for adjacent segment instability （ I degree of vertebral spondylolisthesis ） ,1 case of small joint hyperplasia stage spinal stenosis , 1 case of protrusion of intervertebral disc .In 9 patients with imaging performance ,internal fixation of upper adjacent segment degeneration in 7 cases,internal fixation of the adjacent segment degeneration in 2 cases.Conclusion Inter-body fusion intervertebral fixation in the treatment of lumbar diseases ,adjacent joint is prone to degeneration ,so the destruction of adjacent joint operation should be reduced .

关 键 词：腰椎 关节疾病 关节融合术 

分 类 号：R687.3[医药卫生—骨科学]