腰椎间盘突出症患者行后路椎间融合术后相邻节段退变临床分析  

Posterior intervertebral fusion in patients with lumbar disc prolapse clinical analysis of postoperative adjacent segment degeneration

作　　者：李国富 林子庆 聂友根 苏国义[2] LI Guo-fu;LIN Zi-qing;NIE You-gen(Department of Orthopedics,The Chinese and Western Medicine Hospital of Jiangrnen City Pengjiang District,Jiangmen 529030,Guangdon;Spinal specialist,The Chinese medicine hospital of Guangdong Province)

机构地区：[1]江门市蓬江区中西医结合医院骨一区,广东江门529030 [2]广东省中医院脊柱专科

出　　处：《中国伤残医学》2018年第18期2-4,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：分析腰椎间盘突出症患者行后路腰椎间融合术后相邻节段退变的原因，为积极防治提供参考。方法：回顾性分析我院2011年1月-2013年12月83例腰椎间盘突出症行后路腰椎椎间融合术患者情况，根据末次随访影像学检查相邻节段有无退变分为2组，27例相邻节段退变患者设为退变组，观察临床表现；56例无相邻节段退变患者为对照组，比较2组年龄、骨密度T值、各节段退变情况等。结果：83例患者中发生相邻节段退变27例，发生率为32．53％，其中有症状者占44．44％；无明显症状者占55．56％。退变组平均年龄大于对照组，平均骨密度T值低于对照组（P〈0．05）。退变组单节段、双节段、多节段融合率分别为26．19％、34．61％、46．67％；对照组分别为73．81％、65．38％、53．33％（P〈0．05）。27例术后相邻节段退变患者中L2／L3退变16例（59．26％），L3／L4退变4例（14．81％），L4／L5退变7例（25．93％），L5／S1退变0例（0．0％），L2／L3退变发生率明显高于L4／L5、L2／L4、L5／S1（P〈0．05）；L4／L5退变发生率明显高于L1／L4、L5／S1（P〈0．05）；其中融合节段近端退变发生率为77．78％；远端退变发生率为22．22％（P〈0．05）。结论：腰椎间盘突出症患者行后路腰椎椎间融合术后相邻节段退变发生率较高，年龄大、骨密度T值低、多节段融合患者相邻节段退变发生风险更高，近端节段退变发生率高于远端节段。Objective： To analyze between posterior lumbar fusion in patients with lumbar disc prolapse of adjacent segment degenera- tion after reason, provide reference for positive control. Methods： A retrospective analysis in January 2011 - December 2013 83 cases of patients with posterior lumbar disc prolapse of lumbar intervertebral fusion, according to the last follow - up imaging studies with or without adjacent segment degeneration was divided into two groups of 27 patients with adjacent segment degeneration set to degeneration group, to observe the clinical manifestation; 56 cases as control group, patients with adjacent segment degeneration compared two groups of age and bone mineral density T value, of each segment degeneration, etc. Results： 83 cases of patients with degeneration of adjacent segment de- generation occurred in 27 cases, the incidence was 32.53%, there were symptoms （44.44%） ; No obvious symptoms accounted for 55. 56%. Average age degeneration group than the control group, the average density T value was lower than the control group （P 〈 0.05）. Single segment degeneration group, double segmental, multiple segmental fusion rate were 26.19%, 34.61% and 26.19% respectively; The control group were 73.81%, 65.38% and 53.33 %, respectively （P 〈 0.05 ）. 27 patients with postoperative adjacent segment de- generation in the L2 / L3 degeneration in 16 cases （59.26%）, L3 / IA degeneration in 4 cases （ 14.81% ）, IA / L5 degeneration in 7 cases （25.93%）, and L5 / S1 degeneration 0 eases （0.0%）, L2 / L3 degeneration rate significantly higher than the L4 / L5, L3 and L4, L5 / S1 （P 〈0.05） ; L4 / L5 degeneration rate significantly higher than the L3 and IA, L5 / S1 （P 〈0.05） ; Among them the oc- curring rate of proximal fusion segments degeneration was 77.78% ; The incidence of distal degeneration was 22.22% （P 〈0.05）. Conclusion： Posterior lumbar intervertebral fusion in patients with lumbar disc prolapse with a greater incidence of postoperative adjacent

关 键 词：腰椎间盘突出症 后路椎间融合术 相邻节段退变 分析 

分 类 号：R681.5[医药卫生—骨科学]