选择性融合术治疗退行性腰椎侧凸旋转性骨折的临床和放射学疗效:一项回顾性队列研究。

IF 2.3 Q2 ORTHOPEDICS Asian Spine Journal Pub Date : 2024-06-01 Epub Date: 2024-06-25 DOI:10.31616/asj.2023.0365
Guodong Wang, Keith Dk Luk, Yang Li, Chenggui Zhang, Jianmin Sun
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引用次数: 0

摘要

研究设计目的:研究选择性融合术治疗退行性腰椎侧弯症(DLS)中的旋转性骨质疏松症(RO)的长期临床和放射学效果:文献概述:退行性腰椎侧凸通常伴有旋转性骨畸形,选择性融合旋转性骨畸形是一种常见的手术治疗方案。然而,临床和放射学结果仍存在争议:方法:研究纳入了 54 名连续的 DLS 和 RO 患者。所有患者均接受了选择性 RO 融合术,并接受了至少 2 年的随访。他们被分为两组:第一组为曲线结果:第 2 组的偏移值大于第 1 组(13.4±4.7 mm vs. 9.3±3.5 mm,p 结论:腰椎弧度 30° 的 DLS 选择性 RO 融合术的并发症发生率较高,最终随访的临床结果较差,因此第 1 组的临床和放射学结果保持良好,而第 2 组则不然。
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Clinical and radiological outcomes of selective fusion for rotatory olisthesis in degenerative lumbar scoliosis: a retrospective cohort study.

Study design: Retrospective cohort study.

Purpose: To investigate the long-term clinical and radiological outcomes of selective fusion for rotatory olisthesis (RO) in degenerative lumbar scoliosis (DLS).

Overview of literature: DLS is often associated with RO, and selective fusion of RO is a common surgical treatment option. However, the clinical and radiological outcomes remain controversial.

Methods: A cohort of 54 consecutive patients with DLS and RO was included in the study. All the included patients underwent selective RO fusion and at least 2 years of follow-up. They were divided into two groups: group 1 with a curve <30° and group 2 with a curve ≥30°. The clinical outcomes were evaluated by the Oswestry Disability Index (ODI) and Numerical Rating Scale. The radiological assessment included RO location, offset and subluxated-disc orientation, Cobb angle, and coronal as well as sagittal alignments.

Results: The offset value was greater in group 2 than in group 1 (13.4±4.7 mm vs. 9.3±3.5 mm, p<0.001). The subluxated disc was mainly oriented to the concave side in group 2 (15/21) but to the convex side in group 1 (20/33) (p =0.022). Group 2 had a higher rate of postoperative adjacent RO than group 1 (14/21 vs. 1/33, p<0.001). The ODI was comparable between both groups preoperatively but higher at the final follow-up in group 2 (34.9±9.5) than in group 1 (24.4±6.2). In the multiple logistic regression analysis, the thoracolumbar/lumbar curve was identified as the risk factor for postoperative adjacent RO (odds ratio, 1.400; p=0.007). The receiver operating characteristic analysis verified it with an area under the curve of 0.960 (p<0.001).

Conclusions: The clinical and radiological outcomes were maintained well in group 1 but not in group 2. Selective RO fusion in DLS with a lumbar curve <30° is a rational option. However, it should be avoided in those with a lumbar curve >30° because of a higher complication rate and a worse clinical outcome at the final follow-up.

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来源期刊
Asian Spine Journal
Asian Spine Journal ORTHOPEDICS-
CiteScore
5.10
自引率
4.30%
发文量
108
审稿时长
24 weeks
期刊最新文献
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