成人退行性脊柱侧凸中长节段漂浮融合后L_(5)~S_(1)并发症的发生率和危险因素分析  

Incidence and Risk Factors for L_5-S_(1) Diseases After Long-Level Floating Fusion in Adult Degenerative Scoliosis

作　　者：姜廷华 JIANG Tinghua(Department of Orthopedics,Beijing Huairou Hospital,Beijing 101400,China)

机构地区：[1]北京怀柔医院骨科,北京101400

出　　处：《中国医药指南》2024年第19期32-35,共4页Guide of China Medicine

摘　　要：目的 探析成人退行性脊柱侧凸(ADS)长节段内固定融合远端融合后出现L_(5)~S_(1)并发症的危险因素。方法 回顾性纳入2014年1月至2018年8月接受长节段漂浮融合并随访至少2年的159例ADS患者。依据随访期间是否发生L_(5)~S_(1)并发症分为L_(5)~S_(1)并发症组(47例)和无L_(5)~S_(1)并发症组(112例)。采用多因素Logistic回归分析确定L_(5)~S_(1)并发症的独立危险因素。结果 L_(5)~S_(1)并发症总发生率为29.6%。多因素Logistic回归分析结果显示,骨密度(OR 2.538,P=0.024)、融合节段(OR 2.641,P=0.033)、术后骶骨倾角(OR 1.434,P <0.001)是发生术后L_(5)~S_(1)并发症的独立危险因素,男性(OR 0.420,P <0.001)是发生术后L_(5)~S_(1)并发症的独立保护因素。结论 骨密度、融合节段、术后骶骨倾斜度是L_(5)~S_(1)并发症的独立危险因素,男性是保护因素;男性住院期间的患者管理与围手术期采取积极措施有助于减少术后L_(5)~S_(1)并发症的发生。Objective To explore the risk factors for L_(5)-S_(1) complications after distal fusion with long segmental internal fixation fusion in adult degenerative scoliosis(ADS).Methods A total of 159 patients with ADS who underwent long-segment floating fusion from January 2014 to August 2018 and were followed up for at least 2 years were retrospectively included.They were divided into the L_(5)-S_(1) complication group(n=47) and the no L_(5)-S_(1) complication group(n=112) based on the occurrence of L_(5)-S_(1) complications during follow-up.Multifactorial Logistic regression analysis was used to determine independent risk factors for L_(5)-S_(1) complications.Results The overall incidence of L_(5)-S_(1) complications was 29.6%.The results of multifactorial Logistic regression analysis showed that bone mineral density(OR 2.538,P=0.024),fused segment(OR 2.641,P=0.033),and postoperative sacral inclination(OR 1.434,P<0.001) were the independent risk factors for the occurrence of postoperative L_(5)-S_(1) complications,and males(OR 0.420,P<0.001) were the independent risk factors for the occurrence of independent protective factor for postoperative L_(5)-S_(1)complications.Conclusions Bone density,fusion segment,and postoperative sacral inclination were independent risk factors for L_(5)-S_(1)complications,and men were protective factors;patient management during hospitalisation and active measures taken in the perioperative period in men helped to reduce the occurrence of postoperative L_(5)-S_(1) complications.

关 键 词：成人退行性脊柱侧凸 危险因素 长漂浮融合 L_(5)~S_(1)退行性疾病 

分 类 号：R687.3[医药卫生—骨科学]