后路椎体间融合后早期骶骨倾斜角变化及其分析

发布时间：2018-05-08 07:10

本文选题：组织工程 + 腰椎　；参考：《中国组织工程研究》2017年15期

【摘要】：背景:有研究表明骶骨倾斜角的丢失可能是下腰痛的重要解剖基础之一,腰椎融合术后骶骨倾斜角发生相应变化,其在缓解腰痛方面的临床意义尚需明确。目的:分析L4-5后路椎体间融合后早期骶骨倾斜角变化及其临床意义。方法:纳入L钉内固定后4-5腰椎间盘突出并椎管狭窄症和L4滑脱症经后路椎间盘摘除、椎间植骨、椎弓根的患者共60例,L4-5椎间盘突出并椎管狭窄症38例设为腰椎管狭窄症组,L4滑脱症22例设为腰椎滑脱症组。随访时间12-24个月,对比术前与术后随访时的骶骨倾斜角变化。根据手术后疗效按MacN ab分类分为疗效佳(优)与欠佳(良、中、差),比较分析术后疗效与年龄、性别、骶骨倾斜角变化的相关性。结果与结论:术后12-24个月,腰椎管狭窄症组与腰椎滑脱症组患者骶骨倾斜角均较术前增大(P0.05),而两组之间骶骨倾斜角变化的差异无显著性意义(P0.05)。年龄、性别及骶骨倾斜角变化对术后早期疗效的差异无显著性意义,且无相关性(P0.05)。提示:后路椎间盘摘除、椎间植骨、椎弓根钉内固定术后早期可显著改善腰椎管狭窄症与腰椎滑脱症患者骶骨倾斜角;年龄、性别及骶骨倾斜角变化不是影响术后早期疗效的相关因素。
[Abstract]:Background: some studies have shown that the loss of sacral obliquity angle may be one of the important anatomic bases of low back pain. The sacral inclination angle changes correspondingly after lumbar fusion. The clinical significance of sacral obliquity angle in relieving low back pain needs to be clear. Objective: to analyze the changes and clinical significance of sacral obliquity angle in early stage after L4-5 posterior interbody fusion. Methods: 4-5 lumbar intervertebral disc herniation with lumbar spinal canal stenosis and L 4 spondylolisthesis were treated by posterior discectomy and intervertebral bone grafting after L nail internal fixation. A total of 60 patients with L4-5 disc herniation and spinal canal stenosis were divided into lumbar spondylolisthesis group (L4) and lumbar spondylolisthesis group (22 cases). The sacral obliquity angle was compared between preoperative and postoperative follow-up for 12-24 months. According to the classification of MacN ab after operation, the patients were divided into good (excellent) and poor (good, medium, poor) curative effects. The correlation between postoperative efficacy and age, sex, sacral inclination angle was compared and analyzed. Results and conclusion: the sacral obliquity angle in lumbar spinal stenosis group and lumbar spondylolisthesis group increased significantly 12 to 24 months after operation compared with that before operation (P 0.05), but there was no significant difference between the two groups in sacral obliquity angle (P 0.05). There was no significant difference in age, sex and sacral obliquity in early postoperative outcomes, and there was no correlation between the two groups (P 0.05). The results suggest that posterior discectomy, intervertebral bone grafting and pedicle screw fixation can significantly improve the sacral angle in patients with lumbar spinal stenosis and lumbar spondylolisthesis. Gender and sacral obliquity were not associated with early postoperative outcomes.
【作者单位】：广西科技大学附属柳州市人民医院脊柱外科;暨南大学附属第一医院骨科;
【基金】：国家自然科学基金(81260274)~~
【分类号】：R687.3

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