下腰椎前凸重建与下腰椎融合术后上邻近节段退变再手术的关系  

The relationship between the reconstruction of lower lumbar lordosis and the reoperation of upper adjacent segmental degeneration following lower lumbar fusion

作　　者：方明[1] 陆建猛[1] 王兴武[1] 韦勇力[1] 俞武良[1] 董文伟[1] 陆旻昊 FANG Ming;LU Jian-meng;WANG Xing-wu;WEI Yong-li;YU Wu-liang;DONG Wen-wei;LU Min-hao(Dept of Orthopaedics,the Affiliated Hospital of Medical School of Ningbo University,Ningbo,Zhejiang 315000,China)

机构地区：[1]宁波大学医学院附属医院骨科,浙江宁波315000

出　　处：《临床骨科杂志》2021年第3期335-337,共3页Journal of Clinical Orthopaedics

基　　金：浙江省自然科学基金(编号:LGF20H060008)。

摘　　要：目的探讨下腰椎前凸重建与下腰椎融合术后上邻近节段退变再手术的关系。方法回顾分析32例下腰椎融合术后症状性上邻近节段退变再手术患者(再手术组)和36例下腰椎融合术后无症状性邻近节段退变未再手术患者(未再手术组)资料。比较两组腰椎前凸角(LL)、下腰椎前凸角(LLL)、骨盆入射角(PI)、骨盆倾斜角(PT)、骶骨倾斜角(SS)、腰椎前凸分布指数(LLDI)及LL-PI匹配情况。结果LL、LLL、SS、LL-PI两组比较差异均无统计学意义(P>0.05)。PI、PT再手术组大于未再手术组,LLDI再手术组小于未再手术组,差异均有统计学意义(P<0.05)。结论下腰椎前凸重建不足是下腰椎融合术后上邻近节段退变再手术的重要因素。Objective To investigate the relationship between the reconstruction of lower lumbar lordosis and the reoperation of upper adjacent segmental degeneration following lower lumbar fusion.Methods A retrospective analysis was performed on the data of 32 patients(who suffered from symptomatic degeneration of the upper adjacent segment following lower lumbar fusion,reoperation group)undergoing reoperation and 36 patients(who were without symptomatic degeneration of the adjacent segment following lower lumbar fusion,non-operation group)non-undergoing reoperation.Lumbar lordosis(LL),lower lumbar lordosis(LLL),pelvic incidence(PI),pelvic tilt(PT)and sacral slope(SS),lumbar lordosis distribution index(LLDI),and LL-PI matching condition were compared between the two groups.Results The differences of LL,LLL,SS and LL-PI in two groups had no statistical significances(P>0.05).PI,PT of the reoperation group were larger than the non-reoperation group,and LLDI of reoperation group was smaller than the reoperation group,there were statistical differences(P<0.05).Conclusions The insufficient reconstruction of lower lumbar lordosis maybe is an important factor for reoperation of upper adjacent segmental degeneration following lower lumbar fusion.

关 键 词：腰椎融合术 腰椎前凸角 邻近节段退变 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]