对采用长节段固定术治疗退行性脊柱侧凸后L5-S1融合稳定性影响因素的观察  

Influence factors of L5-S1 fusion stability after long-segment instrumentation for degenerative scoliosis patients

作　　者：张波[1] 姜宇桢 宋卿鹏 安岩[1] 王晋超[1] Zhang Bo;Jiang Yuzhen;Song Qingpeng;An Yan;Wang Jinchao(Department of Spinal Surgery, Beijing Jishuitan Hospital, Beijing 100035, China)

机构地区：[1]北京积水潭医院脊柱外科,100035

出　　处：《骨科临床与研究杂志》2022年第4期240-244,共5页Journal Of Clinical Orthopedics And Research

摘　　要：目的 观察退行性脊柱侧凸畸形长节段固定术后L5-S1融合稳定性的影响因素。方法 2017年月2至2020年2月在北京积水潭医院脊柱外科接受长节段固定至S1的退行性脊柱侧凸畸形患者198例。根据术后L5-S1固定疗效分为成功组(149例)与失败组(49例)。对比两组一般资料的差异,将有差异项带入Logistic回归方程,分析患者术后L5-S1固定是否失败的影响因素。结果 49例L5-S1固定失败,占24.75%。术后两组患者在骨密度T值、感染、早期康复干预方面差异均有统计学意义(P<0.05)。Logistic回归方程表明上述情况均为术后L5-S1固定失败的影响因素。结论 骨密度T值、感染、早期康复干预是接受长节段固定至S1的退行性脊柱侧凸畸形患者发生L5-S1固定失败的原因。对于该类患者,术前应检测骨密度情况,术后做好并发症防治及早期康复干预,确保L5-S1固定成功。Objective To observe the influence factors of L5-S1 fusion stability after long-segment instrumentation for degenerative scoliosis patients.Methods From February 2017 to February 2020,198 degenerative scoliosis patients by the long-segment instrumentation were selected in Department of Spinal Surgery,Beijing Jishuitan Hospital.According to L5-S1 fusion conditions,patients were assigned to success group(149 cases)and failed group(49 cases).Logistic regression equation was used to analyze the influence factors of L5-S1 fusion.Results Forty-nine failed cases of L5-S1 fusion were occurred(24.75%);the bone mineral density(T value),postoperative complications and early rehabilitation interventions between success group and failed group were found to be statistically significant(P<0.05).Logistic regression equation indicated that the above aspects were the influence factors of failed L5-S1 fusion.Conclusion The influence factors of failed L5-S1 fusion are the bone mineral density,postoperative complications and early rehabilitation interventions after long-segment instrumentation for degenerative scoliosis patients.It is important to make the preoperative examination of bone mineral density,avoid the postoperative complications and take the early rehabilitation intervention.

关 键 词：脊柱侧凸 脊柱融合术 影响因素 

分 类 号：R687.3[医药卫生—骨科学]