腰后路减压复位环形融合治疗腰椎双节段椎体滑脱的临床疗效评估

王晟; 李明

doi:10.13406/j.cnki.cyxb.003027

您当前的位置：

首页 >

文章列表页 >

腰后路减压复位环形融合治疗腰椎双节段椎体滑脱的临床疗效评估

骨科学 | 更新时间：2022-06-24

- 腰后路减压复位环形融合治疗腰椎双节段椎体滑脱的临床疗效评估
- Clinical efficacy evaluation of posterior decompression and reduction and circular fusion for the treatment of lumbar double-segment spondylolisthesis
- 重庆医科大学学报 2022年47卷第5期页码：524-528
- 作者机构：
  
  海南医学院第一附属医院关节创伤外科，海南　570100
- 作者简介：
  
  王晟，Email：372009106@qq.com，研究方向：关节创伤外科。
  李明，Email：372009106@qq.com。
- 基金信息：
  
  国家自然科学基金资助项目(81260271)
- DOI：10.13406/j.cnki.cyxb.003027
  中图分类号： R687
- 纸质出版日期：2022-05-28，
  
  收稿日期：2020-07-02，
扫描看全文
王晟, 李明. 腰后路减压复位环形融合治疗腰椎双节段椎体滑脱的临床疗效评估[J]. 重庆医科大学学报, 2022,47(5):524-528.

Cheng Wang, Ming Li. Clinical efficacy evaluation of posterior decompression and reduction and circular fusion for the treatment of lumbar double-segment spondylolisthesis[J]. Journal of Shanxi Agricultural Sciences, 2022,47(5):524-528.
王晟, 李明. 腰后路减压复位环形融合治疗腰椎双节段椎体滑脱的临床疗效评估[J]. 重庆医科大学学报, 2022,47(5):524-528. DOI： 10.13406/j.cnki.cyxb.003027.

Cheng Wang, Ming Li. Clinical efficacy evaluation of posterior decompression and reduction and circular fusion for the treatment of lumbar double-segment spondylolisthesis[J]. Journal of Shanxi Agricultural Sciences, 2022,47(5):524-528. DOI： 10.13406/j.cnki.cyxb.003027.

摘要

目的：

探讨腰椎后路减压复位环形融合治疗腰椎双节段椎体滑脱后临床疗效及腰椎-骨盆矢状位拟合关系的变化。

方法：

回顾性纳入2014年1月至2018年1月海南医学院第一附属医院关节创伤外科收治的接受腰椎后路减压复位环形融合内固定术且资料完整的67例双节段腰椎滑脱症患者。记录患者术前和末次随访时腰腿疼痛视觉模拟（visual analogue scale，VAS）评分及腰椎功能障碍指数（Oswestry disability index，ODI）评分，计算腰椎前凸角（lumbar lordosis，LL）、骶骨倾斜角（sacral slope，SS）、骨盆倾斜角（pelvic tilt，PT）及骨盆入射角（pelvic incidence，PI）并进行分析比较。

结果：

术后12个月，患者腰痛VAS评分由（5.1±0.6）分降至（2.1±0.5）分，ODI评分由（44.5±2.2）分降至（18.6±1.0）分，两者变化差异均具有统计学意义（

0.001）。腰椎LL由47.3°±5.1°降至32.1°±6.0°，SS由40.3°±3.3°降至26.8°±7.5°，PT由34.5°±3.0°降至13.6°±5.0°，PI由63.2°±8.1°降至43.3°±6.6°，4个参数变化差异均有统计学意义（

0.001）。术前LL与SS、PT及PI之间无明显相关性（

0.05）。术后12个月时，LL与SS呈正相关性（

0.05），SS与PT呈负相关性（

0.05），SS与PI呈负相关性（

0.05）。

结论：

腰椎后路减压复位环形融合内固定治疗腰椎双节段椎体滑脱有利于缓解患者腰腿痛，促进患者脊髓神经功能恢复，同时恢复腰椎-骨盆矢状位序列。

Abstract

Objective

To investigate the clinical effect of posterior decompression and reduction of lumbar spine and circular fusion for the treatment of lumbar double-segment spondylolisthesis and the changes in the sagittal fitting relationship between lumbar spine and pelvis.

Methods

A total of 67 patients with double-segment lumbar spondylolisthesis who underwent posterior decompression

reduction

circular fusion and internal fixation of the lumbar spine in the Department of Joint Trauma Surgery

First Affiliated Hospital of Hainan Medical College from January 2014 to January 2018 were retrospectively included in this study. The patient's preoperative and final follow-up for lumbar and leg pain visual analogue scale (VAS) and lumbar spine dysfunction Oswestry disability index (ODI) scores were recorded

and their lumbar lordosis (LL)

sacral slope (SS)

pelvic tilt (PT) and pelvic incidence (PI) were determined and comparatively analyzed.

Results

Twelve months after the operation

the VAS score of the patient's low back pain decreased from (5.1±0.6) points to (2.1±0.5) points

and the ODI decreased from (44.5±2.2) points to (18.6±1.0) points. The differences between the two changes were all statistically significant (

0.001) . LL decreased from 47.3°±5.1°to 32.1°±6.0°

SS decreased from 40.3°±3.3°to 26.8°±7.5°

PT decreased from 34.5°±3.0°to 13.6°±5.0°

and PI decreased from 63.2°±8.1°to 43.3°±6.6°

with significant differences among the four parameters (

0.001) . There was no significant correlation between LL and SS

PT and PI before operation (

0.05) . At 12 months postoperatively

LL was positively correlated with SS (

0.05)

SS was negatively correlated with PT (

0.05)

and SS was negatively correlated with PI (

0.05) .

Conclusion

Posterior lumbar decompression

reduction

circular fusion and internal fixation for the treatment of lumbar double-segment spondylolisthesis is beneficial to alleviate lumbar and leg pain

promote the recovery of spinal nerve function

and re store the lumbar-pelvic sagittal alignment.

关键词

腰椎滑脱症腰椎后路减压融合内固定脊柱序列

Keywords

lumbar spondylolisthesisposterior lumbar decompression fusion and internal fixationspinal alignment

references

Chan AK, Sharma V, Robinson LC, et al. Summary of guidelines for the treatment of lumbar spondylolisthesis[J]. Neurosurg Clin N Am, 2019, 30(3): 353-364.

Alfieri A, Gazzeri R, Prell J, et al. The current management of lumbar spondylolisthesis[J]. J Neurosurg Sci, 2013, 57(2): 103-113.

Ghogawala Z, Dunbar MR, Essa I. Lumbar spondylolisthesis: modern registries and the development of artificial intelligence[J]. J Neurosurg Spine, 2019, 30(6): 729-735.

Bydon M, Alvi MA, Goyal A. Degenerative lumbar spondylolisthesis: definition, natural history, conservative management, and surgical treatment[J]. Neurosurg Clin N Am, 2019, 30(3): 299-304.

Gille O, Bouloussa H, Mazas S, et al. A new classification system for degenerative spondylolisthesis of the lumbar spine[J]. Eur Spine J, 2017, 26(12): 3096-3105.

Beck AW, Simpson AK. High-grade lumbar spondylolisthesis[J]. Neurosurg Clin N Am, 2019, 30(3): 291-298.

Campbell PG, Nunley PD, Cavanaugh D, et al. Short-term outcomes of lateral lumbar interbody fusion without decompression for the treatment of symptomatic degenerative spondylolisthesis at L4-5[J]. Neurosurg Focus, 2018, 44(1): E6.

Goyal A, Kerezoudis P, Alvi MA, et al. Outcomes following minimally invasive lateral transpsoas interbody fusion for degenerative low grade lumbar spondylolisthesis: a systematic review[J]. Clin Neurol Neurosurg, 2018, 167: 122-128.

Chan AK, Bisson EF, Bydon M, et al. Laminectomy alone versus fusion for grade 1 lumbar spondylolisthesis in 426 patients from the prospective Quality Outcomes Database[J]. J Neurosurg Spine, 2018, 30(2): 234-241.

Nakamae T, Nakanishi K, Kamei N, et al. The correlation between sagittal spinopelvic alignment and degree of lumbar degenerative spondylolisthesis[J]. J Orthop Sci, 2019, 24(6): 969-973.

de Kunder SL, Rijkers K, van Kuijk SMJ, et al. A protocol of a randomized controlled multicenter trial for surgical treatment of lumbar spondylolisthesis: the Lumbar Interbody Fusion Trial (LIFT)[J]. BMC Musculoskelet Disord, 2016, 17(1): 417.

Jaeger A, Giber D, Bastard C, et al. Risk factors of instrumentation failure and pseudarthrosis after stand-alone L5-S1 anterior lumbar interbody fusion: a retrospective cohort study[J]. J Neurosurg Spine, 2019, 31(3): 338-346.

Tumialán LM. Future studies and directions for the optimization of outcomes for lumbar spondylolisthesis[J]. Neurosurg Clin N Am, 2019, 30(3): 373-381.

Noorian S, Sorensen K, Cho W. A systematic review of clinical outcomes in surgical treatment of adult isthmic spondylolisthesis[J]. Spine J, 2018, 18(8): 1441-1454.

曾希银, 柯珍勇, 王璨, 等. 后路椎间融合术治疗两节段双侧峡部裂型腰椎滑脱症的效果分析[J]. 实用临床医药杂志, 2018, 22(15): 64-66, 79.

Zeng XY, Ke ZY, Wang C, et al. Effect of posterior interbody fusion on the treatment of two segments lumber spondylolisthesis caused by bilateral isthmus crack[J]. J Clin Med Pract, 2018, 22(15): 64-66, 79.

Luo JQ, Cao K, Yu T, et al. Comparison of posterior lumbar interbody fusion versus posterolateral fusion for the treatment of isthmic spondylolisthesis[J]. Clin Spine Surg, 2017, 30(7): E915-E922.

Berven S, Wadhwa R. Sagittal alignment of the lumbar spine[J]. Neurosurg Clin N Am, 2018, 29(3): 331-339.

Sutovsky J, Sutovska M, Kocmalova M, et al. Degenerative lumbar spondylolisthesis: biochemical aspects and evaluation of stabilization surgery extent in terms of adjacent segment disease theory[J]. World Neurosurg, 2019, 121: e554-e565.

Bozzio AE, Johnson CR, Fattor JA, et al. Stand-alone anterior lumbar interbody, transforaminal lumbar interbody, and anterior/posterior fusion: analysis of fusion outcomes and costs[J]. Orthopedics, 2018, 41(5): e655-e662.

查看原文

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

暂无数据