腰椎融合术后邻近节段退行性变的预防策略及非融合技术应用研究进展  

Prevention strategies for adjacent segment degeneration after lumbar interbody fusion and advances in non-fusion technology applications

作　　者：刘亚明 赵森明 申勇 LIU Yaming;ZHAO Senming;SHEN Yong(Hebei Medical University Graduate College,Shijiazhuang 050017,China;Hebei Provincial Orthopedic Hospital,Shijiazhuang 050051,China;Department of Spine Surgery,The Third Hospital of Hebei Medical University,Shijiazhuang 050051,China Corresponding Authors:SHEN Yong,ZHAO Senming)

机构地区：[1]河北医科大学研究生学院,石家庄050017 [2]河北省骨科医院,石家庄050051 [3]河北医科大学第三医院脊柱外科,石家庄050051

出　　处：《中华骨与关节外科杂志》2025年第4期368-374,共7页Chinese Journal of Bone and Joint Surgery

基　　金：河北省卫生健康委员会医学科学研究计划指导性课题(20241108)。

摘　　要：近年来,腰椎融合术因其良好的疗效和稳定性,成为治疗多种腰椎退行性疾病的经典手术方法。然而,随着技术的不断发展和推广,以及随访时间的延长,邻近节段退行性变(ASD)逐渐受到关注。ASD的出现不仅降低了患者的生活质量,还影响了手术的长期效果。有研究表明,采用微创术式或选择合适的辅助技术减少组织损伤可在一定程度上降低ASD发生率。此外,动态非融合技术的单独应用或与传统内固定技术混合使用的Topping-off技术可以减少刚性固定造成的生物力学变化,从而减缓ASD进展。同时,也有研究指出,控制患者自身的危险因素和提供科学的术后康复指导对降低ASD发生率同样重要。In recent years,lumbar interbody fusion with internal fixation has become a classic operation for various lumbar degenerative diseases due to its efficacy and stability.However,with the advancement and widespread use of the technology,as well as longer follow-up periods,adjacent segment degeneration(ASD)has garnered increased attention.The occurrence of ASD not only reduces patients'quality of life but also impacts long-term surgical outcomes.Studies have shown that the use of minimally invasive surgical methods or the selection of appropriate assistive technologies to minimize tissue trauma can,to some extent,reduce the incidence of ASD.In addition,the use of dynamic non-fusion techniques,either alone or in combination with traditional internal fixation techniques via the topping-off approach can alleviate the biomechanical changes induced by rigid fixation,thereby slowing the progression of ASD.Furthermore,some research indicates that managing patients'risk factors and providing scientific postoperative rehabilitation guidance are equally critical for reducing the incidence of ASD.

关 键 词：腰椎融合术 邻近节段退行性变 微创手术 非融合技术 术后康复 预防策略 

分 类 号：R681.5[医药卫生—骨科学]