骨质疏松与ACDF术后相邻节段骨化的相关性分析  

Correlation Analysis of Osteoporosis and Adjacent-level Ossification after Nterior Cervical Decompression and Fusion

作　　者：黄东海[1] 尤瑞金[1] 肖奕增[1] 黄鹏举[1] 

机构地区：[1]解放军第180医院骨科,福建泉州362000

出　　处：《实用骨科杂志》2017年第4期301-305,共5页Journal of Practical Orthopaedics

基　　金：泉州市科技局社会发展计划重点项目(2013Z117);南京军区医药卫生科研基金课题(14MS093)

摘　　要：目的探讨原发性骨质疏松对颈前路减压椎间融合固定术后相邻节段异位骨化的影响。方法本研究对2009年6月至2013年8月我科收治的采用颈椎前路减压融合术(anterior cervical decompression and fusion,ACDF)治疗颈椎间盘突出症105例患者进行回顾性病例研究,记录患者术前、术后1年骨密度的变化及相邻节段异位骨化的发生率和严重程度。结果术后1年无骨化患者57例,1级骨化患者31例,2级骨化患者17例,未发现相邻节段3级骨化。术前正常骨量患者24例未见明显骨化,10例可见1级骨化,1例2级骨化;低骨量患者中,未见明显骨化患者21例,相邻节段1级骨化患者11例,2级骨化患者8例;骨质疏松患者中,未见明显骨化患者12例,相邻节段1级骨化患者10例,2级骨化患者8例。组间分布进行秩和检验,组间分布不相同(P<0.05);等相关性检验r=0.266,P=0.006。术后1年正常骨量患者21例未见明显骨化,7例可见1级相邻节段骨化,2例2级骨化;低骨量患者中,未见明显骨化患者25例,相邻节段1级骨化患者14例,2级骨化患者5例;骨质疏松患者中,未见明显骨化患者11例,相邻节段1级骨化患者10例,2级骨化患者10例。组间分布进行秩和检验,组间分布不相同(P<0.05);相关性检验r=0.299,P=0.002。骨密度值数值变化等级方面,无相邻节段异位骨化患者中降低12例,无变化30例,升高15例;相邻节段1级骨化患者中,降低17例,无变化12例,升高15例;相邻节段2级骨化患者中,降低13例,无变化3例,升高1例;组间分布不相同(P<0.05);等级资料相关性检验r=-0.447,P=0.000。骨质疏松与相邻节段异位骨化存在明显的相关性,骨质疏松的严重程度与相邻节段异位骨化的发生率和严重程度存在正相关,骨密度数值变化与相邻节段异位骨化的严重程度呈负相关。结论术前和术后骨量异常有可能导致相邻节段异位骨化的发生率升高,并加重相邻节段骨化的严重程度;术�Objective To Investigate the relationship between osteoporosis and adjacent-level ossification after nteri- or cervical decompression and fusion.Methods The clinical data of 105 patients with cervical intervertebral disc hernia- tion who underwent anterior cervical disceetomy and fusion（ACDF） between June 2009 and August 2013 were retro- spectively analyzed .Bone mineral density （BMD）before and after ACDFs ,the incidence of adjacent-level ossification after ACDFs and the degree of adjacent-level ossification after ACDFs were analysed.Results Adjacent-level ossifica- tion after ACDFs related to Low BMD and osteoporosis.Osteoporosis and the severity of adjacent-level ossification after ACDF were positively correlated.The change of Osteoporosis and the severity of adjacent-level ossification after ACDF were negatively correlated.Conclusion It may be helpful to reduce the incidence and the severity of adjacent-level ossi- fication after ACDF by using anti-osteoporosis drug.

关 键 词：颈椎前路减压融合术 ZERO-P 相邻节段异位骨化 骨质疏松 

分 类 号：R681.53[医药卫生—骨科学]