腰椎后路椎体间融合术后至少两年随访的邻近节段退变:矢状脊柱比例的影响:回顾性病例系列。

IF 2.3 Q2 ORTHOPEDICS Asian Spine Journal Pub Date : 2024-10-01 Epub Date: 2024-08-21 DOI:10.31616/asj.2024.0108
Xuepeng Wei, Yu Yamato, Tomohiko Hasegawa, Go Yoshida, Tomohiro Banno, Shin Oe, Hideyuki Arima, Koichiro Ide, Tomohiro Yamada, Kenta Kurosu, Yukihiro Matsuyama
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引用次数: 0

摘要

研究设计目的:研究整个脊柱的矢状面结构及其与后路腰椎椎间融合术(PLIF)后邻近节段退变(ASD)风险的关系:文献概述:尽管 PLIF 的临床疗效令人满意,但它与 ASD 有关。然而,导致 ASD 发生的几何机械变化特征尚不明确:方法:从整个侧位X光片中提取放射学参数。患者分为两组:ASD组(节段性椎体后凸≥10º,和/或椎间盘高度损失≥50%,和/或前后位移≥3毫米)和非ASD组:所有112例腰椎退行性疾病患者均接受了PLIF术。最短随访时间为 2 年,平均随访时间为 63.6 个月。52名患者(46.4%)被归入ASD组,其中13名患者因保守治疗失败而需要再次手术。ASD患者的尾椎和后拐椎(IV)明显增多,而腰椎顶端椎体在术后立即明显向尾部突出。IV位置是ASD的重要风险因素,IV≤5(L1椎体)组的ASD发生率明显高于IV≥5.5(T12-L1椎间盘)组(69.0% vs. 38.6%):IV位置是ASD发生的重要风险因素。尽管术中很难控制IV水平,但我们注意到IV低于T12-L1的患者发生ASD的风险很高。
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Adjacent segment degeneration at a minimum 2-year follow-up after posterior lumbar interbody fusion: the impact of sagittal spinal proportion: a retrospective case series.

Study design: A retrospective cohort study.

Purpose: To investigate the sagittal plane configuration of the entire spine and its association with the risk of adjacent segment degeneration (ASD) after posterior lumbar interbody fusion (PLIF).

Overview of literature: Although PLIF has demonstrated satisfactory clinical outcomes, it is associated with ASD. However, the geometric mechanical changes that contribute to the occurrence of ASD are not well characterized.

Methods: Radiological parameters were extracted from the whole lateral radiographs. Patients were divided into two groups: the ASD group (segmental kyphosis of ≥10º, and/or a ≥50% loss of disc height, and/or ≥3 mm of anteroposterior translation) and the non-ASD group.

Results: All 112 included patients underwent PLIF for lumbar degenerative diseases. The minimum follow-up period was 2 years, with an average follow-up time of 63.6 months. Fifty-two patients (46.4%) were classified into the ASD group and of these, 13 required reoperation due to failure of conservative treatment. Patients with ASD exhibited significantly more caudal and posterior inflection vertebrae (IV), while the lumbar apical vertebra was significantly more caudal immediately after surgery. The IV position was identified as a significant risk factor for ASD, and the ASD incidence was significantly higher in the group where IV ≤5 (L1 vertebral body) than in the group where IV ≥5.5 (T12-L1 disc) (69.0% vs. 38.6%).

Conclusions: The IV position is a significant risk factor for ASD development. Although it is difficult to control intraoperative IV levels, we note a high risk of ASD in patients with IV lower than T12-L1.

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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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