退行性脊柱侧凸畸形长节段固定术后L5S1融合失败的影响因素及其治疗措施  

The Influence Factor Analysis and Therapeutic Measures for L5S1 Fusion Failure after Long-segmental Internal Fixation of Patients with Degenerative Scoliosis Malformation

作　　者：付斌[1] 董毅[1] 丁惠强[1] 赵浩宁[1] FU Bin;DONG Yi;DING Huiqiang;ZHAO Haoning(Deparment of Spinal Orthopedics,the General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院脊柱骨科

出　　处：《宁夏医科大学学报》2019年第10期1021-1024,共4页Journal of Ningxia Medical University

摘　　要：目的探究退行性脊柱侧凸畸形患者长节段固定术后L5S1融合失败的影响因素及治疗措施。方法回顾性分析宁夏医科大学总医院2016年3月-2017年3月收治的接受长节段固定术治疗的退行性脊柱侧凸畸形患者(60例)临床资料,依据术后L5S1融合情况分为融合满意组与融合失败组,观察融合失败的影响因素。结果融合失败组与融合满意组患者在年龄、骨密度T值、患者身体素质、临床操作不熟练、术后并发症发生率、早期干预率差异均有统计学意义(P均<0.05),两组患者腰椎Coob角、腰椎前凸角、体质量指数、腰椎后凸角差异均无统计学意义(P均>0.05)。Logistic回归分析结果显示,骨密度T值、年龄、患者身体素质、术后并发症、早期康复干预是术后L5S1融合失败的主要影响因素。结论对退行性脊柱侧凸畸形患者性长阶段固定术后,L5S1融合失败的主要影响因素包括患者自身情况、术后并发症、早期康复干预等,建议临床医务人员将此作为基础制定相应的融合失败预防措施。Objective To discuss influence factor analysis and therapeutic measures for L5S1 fusion failure after long-segmental internal fixation of patients with degenerative scoliosis malformation.Methods Clinical case data of 60 patients with degenerative scoliosis malformation treated by long-segmental internal fixation in the hospital were collected for retrospective analysis.Based on postoperative L5S1 fusion situation,these patients were divided into fusion success group and fusion failure group.Influence factors for fusion failure were observed.Results There were significant differences in age,T value of bone mineral density,physical quality of patients,unskilled clinical operation,incidence of postoperative complications and early intervention rate between failed fusion group and satisfactory fusion group(P all<0.05)in Coob angle of lumbar vertebrae.There was no significant difference in lumbar kyphosis angle,body mass index and lumbar kyphosis angle(P all>0.05).Regression factor analysis showed that bone mineral density T value,age,patient's physical quality,postoperative complications and early rehabilitation intervention were the main factors influencing the failure of postoperative L5S1 fusion.Conclusion The results of this investigation confirm that the degenerative spine are the main factors influencing the failure of L5S1 fusion after long term fixation in the patients with scoliosis included the patient's own condition,postoperative complications,early rehabilitation intervention and so on.It is suggested that clinical medical staff should take this as the basis to formulate corresponding measures for prevention and control of fusion failure.

关 键 词：退行性脊柱侧凸畸形 长节段固定术 L5S1融合失败 影响因素 

分 类 号：R687.3[医药卫生—骨科学]