| 任东林,宋鑫,倪明,王健,孙万驹,邵正海.后路腰椎椎间融合术中采用延长链接固定治疗腰椎椎间融合术后邻近节段退行性变[J].脊柱外科杂志,2019,17(5):314-318. |
后路腰椎椎间融合术中采用延长链接固定治疗腰椎椎间融合术后邻近节段退行性变  点此下载全文 (Fulltext) |
| 任东林1 宋鑫1 倪明1 王健1 孙万驹1 邵正海2 |
1. 上海健康医学院附属浦东新区人民医院骨科, 上海 200129;
2. 上海开元骨科医院骨科, 上海 201200 |
| 基金项目：上海市浦东新区卫生和计划生育委员会重点专科项目（PWZzk2017-15） |
| DOI：10.3969/j.issn.1672-2957.2019.05.004 |
| 摘要点击次数: 615 |
| 全文下载次数: 334 |
| 摘要： |
| 目的 探讨后路腰椎椎间融合术（PLIF）中采用延长链接固定治疗腰椎椎间融合术后邻近节段退行性变（ASD）的安全性及有效性。方法 回顾性分析2017年4月-2018年3月上海健康医学院附属浦东新区人民医院收治的25例PLIF术后发生ASD患者的临床资料，均采用延长链接固定PLIF治疗。记录手术时间、术中出血量及并发症情况。采用疼痛视觉模拟量表（VAS）评分和Oswestry功能障碍指数（ODI）评估临床疗效。测量手术前后腰椎正侧位X线片及CT上腰椎前凸角、椎间隙高度等影像学参数。结果 所有手术顺利完成，术后随访3~15个月，平均7.9个月；手术时间90~180 min，平均120 min；术中出血量200~800 mL，平均500 mL。所有患者术后VAS评分及ODI均较术前明显改善，影像学测量结果显示手术节段腰椎前凸角、椎间隙高度分别由术前26.96°±5.03°、（6.80±0.87）mm改善至末次随访时37.58°±1.50°、（11.04±0.68）mm，差异均有统计学意义（P<0.05）。椎间植骨均达到骨性融合。所有患者未出现手术相关并发症。结论 PLIF中采用延长链接固定治疗腰椎椎间融合术后ASD安全、有效，具有操作简便、创伤小、术后恢复快等优点，近期随访临床效果良好。 |
| 关键词：腰椎 椎间盘退行性变 脊柱融合术 手术后并发症 再手术 |
| Posterior lumbar interbody fusion with extended-link block fixation for treatment of adjacent segment dgeneration after lumbar interbody fusion Fulltext |
| REN Dong-lin1 SONG Xin1 NI Ming1 WANG Jian1 SUN Wan-ju1 SHAO Zheng-hai2 |
1. Department of Orthopaedics, Pudong New Area People's Hospital, Shanghai University of Medicine and Health Sciences, Shanghai 200129, China;
2. Department of Orthopaedics, Shanghai Kaiyuan Orthopaedics Hospital, Shanghai 201200, China |
| Fund Project: |
| Abstract: |
| Objective To evaluate the safety and efficacy of posterior lumbar interbody fusion (PLIF) with extended-link block for the treatment of adjacent segment degeneration (ASD) after lumbar interbody fusion. Methods The clinical data of 25 patients with ASD after PLIF with pedicle screw internal fixation from April 2017 to March 2018 in Pudong People's Hospital Affiliated to Shanghai University of Medicine and Health Sciences were retrospectively analyzed. All patients were treated by PLIF with extended-link fixation. The operation time, intraoperative blood loss and complications were recorded. The visual analogue scale(VAS) score and Oswestry disablity index(ODI) were used to evaluate the clinical efficacy. Preoperative and postoperative anterior and lateral roentgenographs and CTs of the lumbar vertebra and imaging parameters such as lumbar lordosis angle and intervertebral space height were measured. Results All the operations were successfully completed. All the patients were followd-up for 3-15 (mean 7.9)months. Operation time was 90-180 (mean 120)min, and intraoperative blood loss was 200-800 (mean 500)mL. The VAS score and ODI were significantly improved in all the patients after operation, and the imaging measurement results showed that the anterior lordosis angle and height of intervertebral space were improved from 26.96°±5.03° and (6.80±0.87)mm before operation to 37.58°±1.50° and (11.04±0.68)mm at the final follow-up, both with statistically significant differences (P<0.05). Bone fusion was achieved in all the intervertebral grafts. None of the patients had any surgical complications. Conclusion PLIF with extended-link block fixation is safe and effective in the treatment of ASD after lumbar interbody fusion. It has the advantages of simple operation, less trauma and quick recovery. The clinical effect of short-term follow-up is good. |
| Keywords:Lumbar vertebrae Intervertebral disc degeneration Spinal fusion Postoperative complications Reoperations |
|
|
HTML
查看全文 查看/发表评论 下载PDF阅读器 |
