老年人脊椎骨盆参数:不充分的纠正是否预示着更糟糕的结果?
Masanari Takami1, Shunji Tsutsui1, Keiji Nagata1
1Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan.
Spine surgery and related research
|August 12, 2024
概括
对于老年人的成年脊柱形 (ASD) 手术,骨盆发病率-腰椎形 (PI-LL) 不匹配度高达20°是可以接受的,提供与更严格的目标相匹配的结果.
科学领域:
- 整形外科 整形外科 整形外科
- 脊柱外科手术 脊柱外科手术
- 老年医学 老年医学
背景情况:
- 在老年人中,纠正成年脊柱形 (ASD) 需要仔细考虑斜腰对齐.
- 传统的目标侧重于尽量减少盆腔发病率-腰椎病 (PI-LL) 不匹配 (<10°).
- 在老年患者中,严格的PI-LL不匹配目标的必要性仍在争论中.
研究的目的:
- 为了比较65岁以上患者的ASD纠正融合的临床和放射性结果.
- 评估低校正策略 (10°≤PI-LL≤20°) 与常规目标 (<10°) 的有效性.
主要方法:
- 对102名患者 (>65岁) 的回顾性研究,这些患者接受了ASD的长段融合.
- 根据术后PI-LL不匹配,患者被分为两组:U组 (10°≤PI-LL≤20°) 和M组 (-10°
- 放射学和临床结果 (ODI,SRS-22r,SF-36) 在至少两年的随访期间进行评估.
主要成果:
- 两组之间近端结点形或机械故障率没有显著差异.
- 在最后的随访时,可比的奥斯韦斯特里残疾指数 (ODI) 和视觉模拟尺度 (VAS) 的得分.
- 在不足纠正组 (U组) 中,SRS-22r和ODI的非劣势性和等效性被证明.
- 在SRS-22r的功能领域观察到U组的优越性.
结论:
- 严格遵守PI-LL不匹配<10°对于老年ASD患者的纠正融合是不必要的.
- 一个PI-LL不匹配到20°的可能是一个可接受的斜腰正目标.
- 低校正策略在老年自闭症患者中显示了可比或优异的功能结果.
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