风险因素 早期发病的相邻段变性 在一个段的后腰椎体融合后
Hideaki Nakajima1, Shuji Watanabe2, Kazuya Honjoh2
1Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan. nhideaki@u-fukui.ac.jp.
Scientific reports
|April 21, 2024
概括
在后腰椎体融合后早期发病的相邻段变性与手术前的滑动百分比,骨髓胀和磁盘空间分心有关. 识别这些风险因素可以帮助预测并可能预防这种并发症.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 退行性脊柱疾病是一种退行性脊柱疾病.
- 邻近的细分退化退化.
背景情况:
- 邻细分退化 (ASD) 是后腰间体融合 (PLIF) 后的一个常见并发症.
- 早期发病的ASD与晚期发病的ASD相比,可能呈现出不同的病理特征.
- 了解早期发病ASD的风险因素对于改善外科手术结果至关重要.
研究的目的:
- 为了确定与早期出现的ASD (在2年内) 相关的独立风险因素,从头骨到PLIF细分市场.
- 分析手术前成像和手术参数对ASD发展的影响.
主要方法:
- 对170名接受L4退行性脊髓缩L4退行性脊髓缩治疗的患者进行了回顾性分析.
- 多变量逻辑回归用于确定早期出现ASD的显著风险因素.
- 评估手术前的成像 (骨髓瘤的MRI,真空现象) 和手术变量 (减少滑动,磁盘分心,解压).
主要成果:
- 早期发病的ASD发生在L3-4段20.6%的患者中.
- 早期出现的自闭症的重要独立风险因素包括:手术前较高的滑动率,骨段的脊椎骨髓胀 (OR 16.8),以及外科磁盘空间分散>4.0毫米.
- 手术前骨髓胀患者的早期自闭症发病率为57.1%.
- 真空现象,并发性减压,手术缩小程度和脊柱对齐并不是显著的风险因素.
结论:
- 在相邻的头骨段进行手术前的骨髓胀是PLIF后早期出现ASD的强有力的预测因素.
- 超过4.0毫米的外科磁盘空间分心也与风险增加有关.
- 当手术前骨髓胀存在时,需要仔细考虑融合手术.
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