成年脊柱形患者的临床结局和近端结合失败,纠正为规范性对齐与功能性对齐
Themistocles S Protopsaltis1, Fares Ani1, Alexandra Soroceanu2
11Department of Orthopedic Surgery, NYU Langone Health, New York, New York.
Journal of neurosurgery. Spine
|July 28, 2023
概括
在成年脊柱形患者中实现规范性脊柱对齐导致了更多的近端结节衰竭 (PJF) 和近端结节 (PJK),但没有改善生活质量. 对于更好的结果,建议进行功能性对齐.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 整形外科 整形外科 整形外科
- 生物医学工程 生物医学工程
背景情况:
- 成年脊柱形 (ASD) 在实现最佳外科手术结果方面存在挑战.
- 靠近结节衰竭 (PJF) 和靠近结节 (PJK) 是脊髓融合后的重大并发症.
- 当前的调整目标可能没有充分考虑患者特定的功能状态.
研究的目的:
- 根据ASD患者年龄相应的身体功能,比较PJF和规范调整目标和调整目标之间的功能结果率.
- 在无症状和ASD患者中分析年龄,盆腔发病率 (PI) 和T1盆腔角 (TPA) 之间的关系.
- 确定最佳的调整策略,以减少ASD的并发症和提高生活质量.
主要方法:
- 对288名ASD患者进行脊髓融合后期分析.
- 使用基于PI,年龄和功能状态的线性回归来制定规范性和功能性调整目标.
- 在6周的术后随访中,将患者分为规范性或功能性对齐组的分层.
- 评估PJK和PJF率,以及TPA和PI减去腰椎位症的测量.
主要成果:
- 两组之间基线调整或与健康相关的生活质量 (HRQOL) 没有显著差异.
- 与功能性对齐组相比,具有规范性对齐组的患者显示TPA和PI减去腰部主症显著较小.
- 在规范性调整组中观察到PJK (40%对27.2%) 和PJF (17%对6.8%) 的更高率.
结论:
- 在ASD患者中,对规范性调整的纠正增加了PJK和PJF的风险,但没有改善HRQOL.
- 功能性对齐,反映年龄相匹配的无症状同龄人,推用于ASD患者.
- 将手术目标与功能状态调整可能会减轻并发症并改善患者的治疗结果.
关键词:
人权问题 人权问题在PJF中,PJF是最重要的.在PJK中,PJK就是PJK.在这种情况下,Prom是Prom.年龄的年龄年龄的年龄.调整对齐的情况一个功能性的功能性功能.与健康相关的生活质量.这是一个规范性的规范性.患者报告的结果衡量措施.盆腔发生率的发生率.临近交叉点的故障靠近的结节性光 (Kyphosis)脊椎形是一种脊柱形.更多相关视频
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