腰椎管狭窄症合并腰椎滑脱二次融合手术的危险因素  

Risk factors of secondary fusion surgery for lumbar spinal stenosis complicated with lumbar spondylolisthesis

作　　者：魏礼 胡伟 黄辉 WEI Li;HU Wei;HUANG Hui(Department of Orthopedics,Shangqiu Central Hospital,Shangqiu,Henan 476000,China)

机构地区：[1]商丘市中心医院骨科,河南商丘476000

出　　处：《颈腰痛杂志》2023年第2期159-161,166,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：宁夏回族自治区自然科学基金(编号:NZ16212)。

摘　　要：目的探讨腰椎滑脱(lumbar spondylolisthesis,LS)合并腰椎管狭窄(lumbar spinal stenosis,LSS)二次融合手术的危险因素。方法选择2010年1月~2016年6月在本院接受单纯减压手术的308例LS合并LSS患者作为研究对象,治疗后随访5年,记录患者性别、年龄、体质量指数、腰椎滑脱类型、滑脱节段、临床症状、医学共病、减压医师、减压水平、减压术后二次融合手术(secondary fusion after decompression,SFAD)、SFAD时间等资料,观察影响SFAD的风险因素。结果46例接受SFAD,发生率14.94%。SFAD和非SFAD组的性别、年龄、滑脱类型、间歇性跛行、糖尿病、类风湿性关节炎、心脑血管疾病等资料的差异有统计学意义(P<0.05);两组患者体质量指数、滑脱分度、腰痛VAS评分、腿痛VAS评分、高血压、手术医师、减压水平等资料差异均无统计学意义(P>0.05)。多因素Logistic回归分析显示,类风湿性关节炎、峡部裂性LS是SFAD的风险因素,年龄≥65岁是SFAD的保护性因素。结论年龄<65岁、峡部裂性LS和类风湿性关节炎是SFAD的风险因素。Objective To investigate the risk factors of secondary fusion surgery for lumbar spondylolisthesis(LS)complicated with lumbar spinal stenosis(LSS).Methods From January 2010 to June 2016,308 LS patients complicated with LSS who underwent simple decompression surgery in our hospital were selected in this research.The patients were followed up for 5 years.The gender,age,body mass index,LS type,spondylolisthesis segment,clinical symptoms,medical comorbidity,decompression physician,decompression level,secondary fusion after decompression(SFAD),SFAD time,etc.were recorded,and the risk factors affecting SFAD were observed.Results There were 46 cases received SFAD in 308 patients,with an incidence rate of 14.94%.There were significant differences in gender,age,slippage type,intermittent claudication,diabetes,rheumatoid arthritis and cardio cerebrovascular diseases between SFAD group and non-SFAD group(P<0.05).There were no significant differences in body mass index,type of spondylolisthesis,degree of spondylolisthesis,VAS of low back pain,VAS of leg pain,hypertension,surgeon and decompression level between the two groups(P>0.05).Multivariate logistic analysis showed that rheumatoid arthritis and isthmic LS were the risk factors of SFAD,and age≥65 years old was the protective factor of SFAD.Conclusion Age<65 years,isthmic LS and rheumatoid arthritis are the risk factors of SFAD.

关 键 词：腰椎滑脱 腰椎管狭窄症 单纯减压 减压融合术 风险因素 

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