| 李超,阮狄克,何勍,唐勇.腰椎减压融合术中保留头端后部韧带复合体结构完整性对相邻节段退变的影响[J].脊柱外科杂志,2016,14(5):262-266. |
腰椎减压融合术中保留头端后部韧带复合体结构完整性对相邻节段退变的影响  点此下载全文 (Fulltext) |
| 李超 阮狄克 何勍 唐勇 |
| 海军总医院骨科, 北京 100048 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2016.05.002 |
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| 摘要： |
| 目的 评估腰椎后路融合术中保留后部韧带复合体结构完整性对相邻节段退变的远期影响。方法 对本科2004年1月-2005年12月因腰椎退行性疾患行后路椎板切除减压，经椎弓根内固定、后外侧植骨融合的158例患者进行随访，统计相邻节段影像学退变的发生率，分析相邻节段的转归情况。结果 102例病例获得完整随访，其中26例（25.5%）出现了相邻节段的影像学退变。在融合相邻节段头端和尾端时，退变的发生率分别为19.6%（20/102）和15.2%（10/66），差异无统计学意义（χ2=0.543，P>0.05）。单、双及三节段融合患者的相邻节段退变发生率分别为13.6%（6/44）、26.3%（10/38）和50.0%（10/20），差异有统计学意义（χ2=9.595，P<0.05）。结论 保留头端后部韧带复合体结构的完整性可能减少术后相邻节段退变的发生，全椎板减压的方式应该尽量避免。 |
| 关键词：腰椎 减压术 外科 脊柱融合术 韧带 手术后并发症 |
| Influence of maintenance of head-end posterior ligament complex structure integrity in lumbar spine decompression and fusion on further degeneration of adjacent segments Fulltext |
| LI Chao RUAN Di-ke HE Qing TANG Yong |
| Department of Orthopedics, Navy General Hospital, Beijing 100048, China |
| Fund Project: |
| Abstract: |
| Objective To identify the long-term influence of maintain of the posterior ligament complex structure integrity in lumbar posterior lateral fusion(PLF) on degeneration of the adjacent lumbar vertebrae. Methods The retrospective study included 158 patients who underwent surgery of PLF. The incidence of adjacent disc degeneration(ASD) was calculated and the outcome of adjacent discs was analyzed. Results Finally 102 patients with completely follow-up records were enrolled into the retrospective study,out of whom 26(25.5%) were identified having ASD on roentgenograph. For the cranial and caudal level,ASD was found in 20(20/102,19.6%) and 10(10/66,15.2%),respectively and the difference was not statistically significant(χ2=0.543,P>0.05). The incidence of ASD of single-,double- and triple-level fusion was 13.6%(6/44),26.3% (10/38) and 50.0%(10/20),with a significant difference(χ2=9.595,P<0.05). Conclusion Containing integrity of lumbar posterior ligament complex during decompression may decrease the incidence of ASD,and total laminectomy should be avoided. |
| Keywords:Lumbar vertebrae Decompression surgical Spinal fusion Ligaments Postoperative complications |
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