李超;巴兆玉;黄宇峰;洪潮;吴德升;

• 1:上海市同济大学附属东方医院脊柱外科
• 2:上海市第七人民医院骨伤科

摘要(Abstract)：

腰椎后路椎弓根钉内固定融合术现已广泛应用于治疗腰椎退行性疾病、畸形、腰椎滑脱和脊柱肿瘤等,坚强内固定和360°融合亦被视为脊柱稳定手术的金标准。相邻节段退变(adjacent segment degeneration,ASD)是腰椎固定术后相邻节段最常见的病变。随着内固定器械的日趋成熟,术后相邻节段退变引起了越来越多人的关注,研究其发生机制和影响因素,如何有效治疗和预防相邻节段退变的发生逐渐成为研究的热点。本文就腰椎后路内固定术后相邻节段退变的概念、发生率、发生机制、影响因素和治疗作一综述。

关键词(KeyWords)： 腰椎;内固定;相邻节段退变

Abstract:

Keywords:

基金项目(Foundation): 上海市科学技术委员会科研项目,课题名称:腰椎后外侧融合椎弓根钉置入对固定及相邻节段椎间盘影响的基础及临床应用研究(编号:12411951202);; 浦东新区科技发展基金创新资金项目(编号:PKJ2013-Y25);; 浦东新区卫生系统重点学科建设资助项目(编号:PWZX2014-17)

作者(Author): 李超;巴兆玉;黄宇峰;洪潮;吴德升;

Email:

DOI:

参考文献(References)：

• [1]Lund T,Oxland TR.Adjacent level disk disease is it really a fusion disease[J].Orthop Clin North Am,2011,42(4):529-541.
• [2]Ghiselli G,Wang JC,Bhatia NN,et al.Adjacent segment degeneration in the lumbar spine[J].J Bone Joint Surg Am,2004,86(7):1497-1503.
• [3]Ha KY,Schendel MJ,Lewis JL,et al.Effect of immobilization and configuration on lumbar adjacent segment biomechanics[J].J Spinal Disord,1993,6(3):99-105.
• [4]Lee CS,Hwang CJ,Lee SW,et al.Risk factors for adjacent segment disease after lumbar fusion[J].Eur Spine J,2009,18(11):1637-1643.
• [5]Kaito T,Hosono N,Mukai Y,et al.Induction of early degeneration of the adjacent segment after posterior lumbar interbody fusion by excessive distraction of lumbar disc space[J].J Neurosurg Spine,2010,12(7):671-679.
• [6]Phillips FM,Reuben J,Wetzel FT.Intervertebral disc degeneration adjacent to a lumbar fusion.An experimental rabbit model[J].J Bone Joint Surg Br,2002,84(2):289-294.
• [7]Kim HJ,Kang KT,Son J,et al.The influence of facet joint orientation and tropism on the stress at the adjacent segment after lumbar fusion surgery:a biomechanical analysis[J].Spine J,2015,15(8):1841-1847.
• [8]Goto K,Tajima N,Chos AE,et al.Effects of lumbar spinal fusion on the other lumbar intervertebral levels(three-dimensional finite element analysis)[J].J Orthop Sci,2003,8(4):577-584.
• [9]黄晓川,康两期,沙漠,等.相邻节段退行性变是自然过程还是融合相关的现象[J].中国骨与关节损伤杂志,2014,29(9):891
• [10]Videbaek TS,Egund N,Christensen FB.Adjacent segment degeneration after lumbar spinal fusion:the impact of anterior column support.A randomized clinical trial with aneight to thirteen year magnetic resonance imaging follow-up[J].Spine(Phila Pa 1976),2010,35(22):1955-1964.
• [11]Bae JS,Lee SH,Kim JS,et al.Adjacent segment degeneration after lumbar interbody fusion with percutaneous pedicle screw fixation for adult low-grade isthmic spondylolisthesis:minimum 3 years of follow-up[J].Neurosurgery,2010,67(6):1600-1607.
• [12]Chen CS,Cheng CK,Liu CL.A biomechanical comparison of posterolateral fusion and posterior fusion in the lumbar spine[J].J Spinal Disord Tech,2002,15(1):53-63.
• [13]Ma J,Fan S,Zhao F.Intraoperative malposition of pedicle probe or screws:a potential cause of the acceleration of degeneration in superior adjacent intervertebral disc[J].Med Hypotheses,2011,77(6):1102-1104.
• [14]Wiltse LL,Radecki SE,Biel HM,et al.Comparative study of the incidence and severity of degenerative change in the transition zones after instrumented versus noninstrumented fusions of the lumbar spine[J].J Spinal Disord,1999,12(1):27-33.
• [15]Gillet P.The fate of the adjacent motion segments after lumbar fusion[J].J Spinal Disord Tech,2003,16(4):338-345.
• [16]刘则征,张忠民,金大地.腰椎融合内固定术后邻近节段退变的影响因素[J].南方医科大学学报,2010,30(5):1134-1137.
• [17]Sergei M,Dmitry P,Dmitry M,et al.Risk factors for adjacent segment disease development after lumbar fusion[J].Asian Spine J,2015,9(2):239-244.
• [18]Anandjiwala J,Seo JY,Ha KY.Adjacent segment degeneration after instrtmented posterolateral lumbar fusion:a prospective cohort study with a minimum five year follow-up[J].Eur Spine J,2011,20(11):1951-1960.
• [19]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.
• [20]Tang S,Xu W.Does disc space height of fused segment affect adjacent disc degeneration in anterior lumbar interbody fusion?A radiological study[J].Iran Red Crescent Med J,2012,14(3):139-145.
• [21]Aota Y,Kumano K,Hirabayashi S.Postfusion instability at the adjacent segments after rigid pedicle screw fixation for degenerative lumbar spinal disorders[J].J Spinal Disord,1995,8(5):464-473.
• [22]Kim KH,Lee SH,Shim CS,et al.Adjacent segment disease after interbody fusion and pedicle screw fixations for isolated L4、5spondylolisthesis:a minimum five year follow-up[J].Spine(Phila Pa1976),2010,35(6):625-634.
• [23]郑晓勇,侯树勋,李利,等.腰椎融合术后相邻节段的退变与临床疗效的关系[J].中国矫形外科杂志,2009,17(23):1782-1785.
• [24]Chen WJ,Lai PL,Niu CC,et al.Surgical treatment of adjacent instability after lumbar spine fusion[J].Spine,2001,26(14):519-524.
• [25]Djurasovic M,Glassman SD,Howard JM.Health-related quality of life improvements in patients undergoing lumbar spinal fusion as a revision surgery[J].Spine,2011,36(4):269-276.