腰椎后路融合术后邻近节段早期改变
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江苏省卫生厅科技兴卫工程(RC2007059);江苏省六大人才项目(07-B-043)


The early changes of adjacent segment after posterior fusion of lumbar
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    摘要:

    目的:通过对腰椎后路融合术后患者邻近节段影像学指标的测量,探讨邻近节段退变的发生-发展情况-方法:随访组为本院脊柱中心2004年~2007年间21位行腰椎后路融合术的患者,对照组A为本院门诊行腹部CT扫描的患者,对照组B为本院门诊行腰椎侧位片的患者-随访组患者术后无邻近节段病(Adjacent Segment Degeneration,ASD)的发生,亦无渐进的神经症状-测量患者邻近节段黄韧带厚度-小关节间隙宽度-侧隐窝宽度-小关节极性-椎板角并与对照组进行比较-结果:和对照组相比,随访组部分节段黄韧带明显增厚(P < 0.05),但尚未达到黄韧带肥厚的诊断标准-小关节极性:部分节段随访组大于对照组,有显著的统计学差异(P < 0.05)-小关节间隙宽度:和对照组相比数据无显著的统计学差异(P > 0.05)-椎板角:和对照组相比数据无显著的统计学差异(P > 0.05)-侧隐窝宽度:和对照组相比无显著的统计学差异(P > 0.05)-结论:腰椎后路融合术后,由于力学分布的变化,邻近节段出现渐进式的改变,这些改变包括韧带增生,小关节退变等-连续-动态地观察腰椎后路融合术后患者黄韧带的厚度-小关节极性等数据,可为评估邻近节段退变的进展和防治邻近节段退变的发生提供重要的依据-

    Abstract:

    Objective:To explore the early development of adjacent segment after posterior fusion of lumbar. Methods:From 2004 to 2007, 21 pateints with thoracolumbar fractures were treated by pedicle fixation combined with lumbar posterior fusion as experimental group. The patients from the out-patient department without any vertebral diseases were as control group. We measured the width of ligamentum flava, small joint, and intervertebral foramen, the facet tropism and the facet angle. Results:The width of ligamnetum flavum of experiment group were increased compared with the control group. The facet tropism were bigger in experimental group than the control group. There were not statistical significance in the width of small joint and facet angle between the experimental group and the control group. Conclusion:The adjacent segment were changed after lumbar posterior fusion due to the change of biomechanical force. It is very important for clinical guide to understand the changes of adjacent segment.

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李 丁,凡 进,沈国蔚,张 宁,殷国勇,胡志毅,金正帅.腰椎后路融合术后邻近节段早期改变[J].南京医科大学学报(自然科学版),2009,29(2):240-244

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  • 收稿日期:2009-10-30
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