成人脊柱畸形手术后远端交界区失败相关危险因素的系统回顾  

Systematic review of risk factors associated with distal junction failure after spinal deformity surgery in adults

作　　者：张猛[1] 张怀栓[1] 杨广辉[1] 潘玉林[1] 郭小伟[1] 熊森 ZHANG Meng;ZHANG Huai-shuan;YANG Guang-hui;PAN Yu-lin;GUO Xiao-wei;XIONG Sen(Department of Spine,Zhengzhou Orthopedic Hospital(Zhengzhou Orthopedic Hospital Affiliated to Henan University),Zhengzhou,Henan 450000,China)

机构地区：[1]郑州市骨科医院(河南大学附属郑州市骨科医院)脊柱外科,河南郑州450000

出　　处：《颈腰痛杂志》2023年第1期8-11,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的 系统性回顾成人脊柱畸形(adult spinal deformity, ASD)手术后远端交界区失败(distal junctional failure, DJF)的发生率及相关危险因素。方法 检索中英文数据库中的成人脊柱畸形手术文献,对文献质量评价后,观察DJF发生率及相关风险因素。结果 共获得13篇文献纳入研究,其中英文文献12篇,中文1篇。13篇文献的NOS得分7~8分。13篇文献均描述了DJF发生率,发生率为1.52%~15.56%不等,总体DJF发生率为3.47%(83/2393)。12项研究描述了翻修率,范围为7.61%~42.11%,总体翻修率13.22%(304/2299)。DJF的发生原因从低到高分别为:过渡综合征(4.82%)、邻近节段疾病(12.05%)、远端交界性后凸(18.07%)、假关节形成(22.89%)、器械因素(28.92%)。不同年龄和手术技术组别之间的DJF发生率差异均无统计学意义(P>0.05);椎间融合和L5融合的患者DJF发生率显著升高(P<0.05)。结论 ASD术后的总体DJF发生率为3.47%,椎间融合和L5融合可能是术后发生DJF的风险因素。Objective To systematically review the incidence and risk factors of distal junction failure(DJF) after surgery for adult spinal deformity(ASD). Methods The literatures of ASD surgery in Chinese and English databases were searched. After evaluating the quality of the literatures, the incidence of DJF and related risk factors were observed. Results A total of 13 literatures were included in the study, including 12 articles in English and 1 article in Chinese. The NOS score of 13 literatures was 7-8. The incidence of DJF ranged from 1.52% to 15.56%, and the overall incidence rate of DJF was 3.47%(83/2393). 12 studies described the renovation rate, ranged from 7.61% to 42.11%, and the overall renovation rate was 13.22%(304/2299). The causes of DJF from low to high were transition syndrome(4.82%), adjacent segment disease(12.05%), distal borderline kyphosis(18.07%), pseudojoint(22.89%) and instrument factors(28.92%). There was no significant difference in the incidence of DJF between different age and surgical technique groups(P>0.05), and the incidence rate of DJF was significantly higher in patients with interbody fusion and L5fusion(P<0.05). Conclusion The overall incidence rate of DJF after ASD is 3.47%. Intervertebral fusion and L5fusion may be the risk factors of DJF after ASD.

关 键 词：成人脊柱畸形 远端交界区失败 危险因素 

分 类 号：R682.13[医药卫生—骨科学]