使用全局斜弹性来预测脊柱形手术后的近端结点形
Ryan G Eaton1, Joshua L Wang1, Vikas Munjal2
11Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio; and.
Journal of neurosurgery. Spine
|October 27, 2023
概括
在成年脊柱形手术之前,脊柱刚硬会增加近端结节 (PJK) 的风险. 脊柱灵活性可能会影响手术结果,但需要进一步的长期研究.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 整形外科手术 整形外科手术
- 变形纠正 变形纠正 变形纠正
背景情况:
- 在成年脊柱形手术 (ASD) 后,对功能结果至关重要的是形对齐.
- 一个硬的脊柱可以增加杆臂,可能导致近端结节 (PJK).
研究的目的:
- 为了调查手术前的全球脊柱灵活性,称为全球斜灵活性 (GSF),预测ASD手术后的PJK发病率.
- 确定脊柱刚性是否与手术后1年PJK风险更高有关.
主要方法:
- 长段胸脊柱融合与骨盆固定的回顾性审查.
- 根据C7斜垂直轴的变化,患者被分为"灵活" (GSF>3.7厘米) 和"刚性" (GSF ≤3.7厘米) 队列.
- 分析包括人口统计数据,X光照,并发症和患者报告的结果指标 (PROM).
主要成果:
- 分析了85名患者;37名患者被归类为刚性患者,48名患者被归类为柔性患者.
- 刚性患者在1年内显示出近端交点角增加 (ΔPJCA) ≥10°的显著更高的发病率 (51.4%对29.3%,p=0.049).
- 在1年或2年后的组之间没有观察到重新操作率或PROMs的显著差异.
结论:
- 手术前的全球脊柱硬性是ASD手术后PJK发展的独立风险因素.
- 脊柱的灵活性可能会影响ASD手术结果,尽管PJK是与性相关的主要问题.
- 需要进行更长的随访,以充分理解脊柱刚性与重新手术率之间的关系.
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