Risk factors and clinical significance of posterior slip of the proximal vertebral body after lower lumbar fusion  

作　　者：Jia-Jun Zhu Yi Wang Jun Zheng Sheng-Yang Du Lei Cao Yu-Ming Yang Qing-Xi Zhang Ding-Ding Xie 

机构地区：[1]Department of Spinal Surgery,Xuzhou First People’s Hospital,Xuzhou 221112,Jiangsu Province,China [2]Department of Spinal Surgery,The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University,Xuzhou 221112,Jiangsu Province,China [3]Department of Spinal Surgery,The Affiliated Hospital of China University of Mining and Technology,Xuzhou 221112,Jiangsu Province,China

出　　处：《World Journal of Clinical Cases》2024年第26期5885-5892,共8页世界临床病例杂志

基　　金：Supported by The Youth Medicine Technology Innovation Project of Xuzhou Health Commission,No.XWKYHT20200026.

摘　　要：BACKGROUND Adjacent segment disease(ASD)after fusion surgery is frequently manifests as a cranial segment instability,disc herniation,spinal canal stenosis,spondylolisthesis or retrolisthesis.The risk factors and mechanisms of ASD have been widely discussed but never clearly defined.AIM To investigate the risk factors and clinical significance of retrograde movement of the proximal vertebral body after lower lumbar fusion.METHODS This was a retrospective analysis of the clinical data of patients who underwent transforaminal lumbar interbody fusion surgery between September 2015 and July 2021 and who were followed up for more than 2 years.Ninety-one patients with degenerative lumbar diseases were included(22 males and 69 females),with an average age of 52.3 years(40-73 years).According to whether there was retrograde movement of the adjacent vertebral body on postoperative X-rays,the patients were divided into retrograde and nonretrograde groups.The sagittal parameters of the spine and pelvis were evaluated before surgery,after surgery,and at the final follow-up.At the same time,the Oswestry Disability Index(ODI)and Visual Analogue Scale(VAS)were used to evaluate the patients’quality of life.RESULTS Nineteen patients(20.9%)who experienced retrograde movement of proximal adjacent segments were included in this study.The pelvic incidence(PI)of the patients in the retrograde group were significantly higher than those of the patients in the nonretrograde group before surgery,after surgery and at the final follow-up(P<0.05).There was no significant difference in lumbar lordosis(LL)between the two groups before the operation,but LL in the retrograde group was significantly greater than that in the nonretrograde group postoperatively and at the final follow-up.No significant differences were detected in terms of the|PI–LL|,and there was no significant difference in the preoperative lordosis distribution index(LDI)between the two groups.The LDIs of the retrograde group were 68.1%±11.5%and 67.2%±11.9%,respectively,wh

关 键 词：Adjacent segment disease Posterior vertebral slip Sagittal alignment of spine-pelvis Lower lumbar fusion Quality of life 

分 类 号：R68[医药卫生—骨科学]