腰椎椎间融合术后笼架后移危险因素分析Factors related to cage displacement after lumbar interbody fusion
王丹;蔡贤华;徐峰;蒋欣浩;黄威;袁彪;
摘要(Abstract):
[目的]探讨腰椎椎间融合术后笼架后移危险因素。[方法]回顾分析692例腰椎后路椎间融合手术患者临床资料。将患者性别、年龄、合并症、住院天数、支具佩戴时间、椎间隙高度恢复情况、笼架置入深度、椎弓根钉棒稳定情况、椎间隙前凸角恢复情况纳入分析,采用单项因素与二元多因素逻辑回归分析笼架后移的相关因素。[结果] 629例患者中,发生笼架移位的23例,占3.32%。单项因素分析表明:与未后移组相比,后移组年龄大、术后佩戴支具时间短、椎间盘突出症比率低、骨质疏松比率高、激素使用比率高、超重比率高、双节段融合比率高、术后椎间隙高度恢复不良比率高、术后前凸角恢复不良比率高、术后笼架置入深度不良比率高、术后椎弓根钉棒系统稳定不良比率高,差异均有统计学意义(P<0.05)。逻辑回归表明:术后佩戴支具时间是笼架后移的保护因素(OR=0.374,P<0.001)。而术后椎间隙高度恢复不良(OR=263.109,P<0.001),笼架置入深度不良(OR=27.931,P<0.001),骨质疏松症(OR=13.609,P=0.007)和超重(OR=8.133,P=0.038)是笼架后移的危险因素。[结论]腰椎椎间融合术后笼架后移由多因素导致。骨质疏松、超重、术后椎间隙高度恢复不良、笼架置入深度不良和术后佩戴支具时间为笼架后移独立影响因素。
关键词(KeyWords): 腰椎椎间融合术;笼架;后移;并发症
基金项目(Foundation):
作者(Authors): 王丹;蔡贤华;徐峰;蒋欣浩;黄威;袁彪;
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