在L5-S1前腰椎间体融合后,对脊椎脊柱对齐的相互变化
James J Zhou1, S Harrison Farber1, Nima Alan1
1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
World neurosurgery
|May 16, 2024
概括
在L5-S1的前腰椎间体融合 (ALIF) 增加了融合部位的 lordosis,但在上腰椎中减少了它. 这种手术导致骨盆前转和整体脊骨骨对齐的放松.
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
- 退行性脊柱疾病是一种退行性脊柱疾病.
背景情况:
- 腰椎退行性疾病往往导致腰椎症 (LL) 的减少.
- 在L5-S1圆盘空间的前腰椎间体融合 (ALIF) 是一种常见的程序,以改善LL,细分主和斜腰平衡.
- 了解L5-S1 ALIF对整体脊骨皮层调整的影响,对于手术规划和患者的治疗结果至关重要.
研究的目的:
- 为了研究L5-S1 ALIF之后的脊骨皮层对齐的相互变化.
- 分析L5-S1 ALIF对骨盆倾斜,交叉斜率,腰椎律分布和斜腰垂直轴的影响.
主要方法:
- 在2016年11月至2021年10月期间接受L5-S1 ALIF治疗的48名患者的回顾性审查.
- 术前和术后放射测量脊骨参数,包括骨盆倾斜,十字斜率,LL (近端,远端,总),细分主位,和斜垂直轴.
- 立即和延迟的术后放射性发现的比较,以评估短期和中期变化.
主要成果:
- L5-S1 ALIF显著增加了L5-S1细分主症和整体LL.
- 患者表现出下降的骨盆倾斜和近端LL (L1-L4),以及增加的十字斜率和远端LL (L4-S1).
- 观察到主病分布指数的显著增加,表明主病向L5-S1段转移.
结论:
- L5-S1 ALIF有效地恢复了化部分的 lordosis,并改善了整体LL.
- 这种手术与骨盆前转和靠近LL的补偿性下降有关.
- 这些发现表明补偿机制的潜在逆转,导致L5-S1 ALIF后的脊骨皮层对齐的整体放松.
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