退行性腰椎滑脱患者后路腰椎椎体间融合术后疗效影响因素的研究进展  

Progression of the influencing factors for the efficacy of posterior lumber interbody fusion in patients with degenerative lumbar spondylolisthesis

作　　者：柳栋元 刘晓亮 杨永杰 关海山[1] Liu Dongyuan;Liu Xiaoliang;Yang Yongjie;Guan Haishan(Department of Orthopaedics,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第二医院骨科,太原030001

出　　处：《中华骨科杂志》2024年第19期1305-1312,共8页Chinese Journal of Orthopaedics

摘　　要：后路腰椎椎体间融合术(posterior lumber interbody fusion,PLIF)是目前公认的治疗退行性腰椎滑脱(degenerative lumbar spondylolisthesis,DLS)安全有效的脊柱外科技术,被广泛应用于临床,但临床上仍有部分患者术后总体疗效不佳。为探讨影响PLIF术后临床结果的相关因素及其发生机制,多年来众多学者进行了大量的临床研究。然而,由于不同研究采用的方法及纳入的研究因素各异,因此得出的结论也不尽相同,甚至完全相反。本文综述近年来PLIF术后疗效影响因素的研究结果,分析年龄、性别、体质指数、骨密度、术前症状持续时间、滑脱椎体是否复位、脊柱-骨盆矢状位参数(包括腰椎前凸角、骶骨倾斜角、骨盆倾斜角、骨盆入射角、脊柱-骨盆匹配值及Roussouly分型)和其他患者因素(合并基础疾病和不良生活习惯)对PLIF疗效的潜在影响,以期为提高DLS患者术后生活质量及功能恢复提供参考。Posterior lumbar interbody fusion(PLIF)is currently well accepted and considered as safe and effective spinal surgical technique for the treatment of degenerative lumbar spondylolisthesis,and is widely used in clinical practice.But there are still some cases with poor overall postoperative efficacy.In order to discuss the relevant factors and mechanisms affecting the clini-cal outcomes of PLIF surgery,many scholars have conducted a large number of clinical studies over the years.However,due to the different methods and the factors among included studies,the conclusions reached were also different or even completely opposed.This article reviews the research results of various influencing factors of the postoperative efficacy of PLIF in recent years,and ana-lyzes age,gender,body mass index,bone mineral density,duration of preoperative symptoms,whether the sliding vertebral body is reduced,spine-pelvic sagittal parameters(including lumbar lordosis,sacral slope,pelvic tilt,pelvic incidence,pelvic incidence-lumbar lordosis and Roussouly classification)and other factors(underlying diseases and poor lifestyle habits)on the clinical ef-fects of PLIF,in order to provide a reference for further improving the postoperative quality of life and functional recovery of pa-tients with degenerative lumbar spondylolisthesis.

关 键 词：腰椎 脊椎滑脱 脊柱融合术 影响因素分析 

分 类 号：R687.3[医药卫生—骨科学]