付海祥;曹兴兵;陈奇;富仁杰;卞元健;徐晓峰;

• 1:江苏大学附属医院脊柱外科

摘要(Abstract)：

[目的]观察分析腰椎间盘突出症后路椎间融合术后邻近节段退变的发生及其危险因素。[方法]回顾本院2012年收治的腰椎间盘突出症患者67例。34例融合,33例保守作为对照。入院、末次随访时评测MRI、X线片参数:近端椎间高度丢失、近端小关节退变。采用SPSS 19进行统计分析。[结果]平均随访(25±2.4)个月(18~28个月)。椎间高度组内对照差异均有统计学意义(P<0.01),高度丢失组间对照差异有统计学意义(t=-6.969,P=0.000)。小关节退变的组内对照差异均有统计学意义(P<0.05),末次随访时组间差异有统计学意义(P=0.001),入院时组间差异无统计学意义(P>0.05)。前凸角异常是邻近节段退变的独立危险因素(P=0.043)。[结论]腰椎邻近节段退变是自然病程,融合加速该病程。前凸角异常是退变的重要因素,予适当矫正。

关键词(KeyWords)： 腰椎融合;邻近节段退变;腰椎前凸角

Abstract:

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作者(Author): 付海祥;曹兴兵;陈奇;富仁杰;卞元健;徐晓峰;

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参考文献(References)：

• [1]Park P,Garton HJ,Gala VC,et al.Adjacent segment disease after lumbar or lumbosacral fusion:review of the literature[J].Spine,2004,29(17):1938-1944.
• [2]刘钊,沈惠良,张庆明,等.正常成人腰椎矢状面曲度改变及其影响因素[J].中国脊柱脊髓杂志,2011,21(6):493-496.
• [3]Kim HJ,Kang KT,Chun HJ,et al.The influence of intrinsic disc degeneration of the adjacent segments on its stress distribution after one-level lumbar fusion[J].Eur Spine J,2015,24(4):827-837.
• [4]Dekutoski MB,Schendel MJ,Ogilvie JW,et al.Comparison of in vivo and in vitro adjacent segment motion after lumbar fusion[J].Spine,1994,19(15):1745-1751.
• [5]Kim YE,Choi HW.Effect of disc degeneration on the muscle recruitment pattern in upright posture:a computational analysis[J].Comput Methods Biomech Biomed Eng,2014,18(15):1622-1631.
• [6]Soh J,Lee JC,Shin BJ.Analysis of risk factors for adjacent segment degeneration occurring more than 5 years after fusion with pedicle screw fixation for degenerative lumbar spine[J].Asian Spine J,2013,7(4):273-281.
• [7]陈涛,黎观保,梁科友,等.脊柱-骨盆矢状面平衡及其在脊柱疾病治疗中的作用[J].中国组织工程研究,2013,13(13):2423-2430.