脊柱对齐对邻近段子疾病和短段腰部神经融合后退化的影响
Giuseppe Loggia1, Mazda Farshad1, Moritz Jokeit2
1Department of Orthopaedic Surgery, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008 Zürich, Switzerland.
概括
在短段腰部神经融合后的相邻细分病 (ASDis) 和退行 (ASDeg) 并没有与脊骨皮层对齐 (SPA) 有显著的联系. 然而,相邻的细分变化会对患者的长期结果产生负面影响,这凸显了预防ASDis的必要性.
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
- 生物机械分析分析
背景情况:
- 在腰部融合后,相邻细分病 (ASDis) 和退化 (ASDeg) 是常见的.
- 脊骨皮层对齐 (SPA) 在短段腰部神经融合后对这些并发症的影响尚不清楚.
- 长期结果和SPA在这些特定情况下的作用需要进一步调查.
研究的目的:
- 评估全球和远端腰部SPA与ASDis和ASDeg发展之间的关联.
- 评估患者报告的结果措施 (PROMs) 与相邻的细分变化相关.
- 为了研究短段腰骨神经融合后的长期结果.
主要方法:
- 对86名接受L4-S1融合治疗的患者进行了回顾性队列研究,随访时间至少为5年 (平均为12年).
- 术前和术后的全球和远部腰部SPA参数的分析.
- 主要结局:ASDis (手术) 或ASDeg (放射) 的发展. 二次结果:奥斯韦斯特里残疾指数 (ODI) 和EQ5D5L分数.
主要成果:
- 在术前或术后的SPA和ASDis或ASDeg的发展之间没有发现显著的关联.
- 患者与相邻的细分变化,无论手术干预,报告显著更糟糕的长期PROMs (较高的ODI,较低的EQ5D5L).
- 在ASDis组中,下骨盆发生率和十字斜率趋向于显著,但没有达到统计学意义.
结论:
- 脊骨骨对齐不是一个重要的预测邻近的细分体疾病或短细分体腰骨神经融合后的退化.
- 邻近的细分变化显著损害了患者报告的长期结果,强调了预防策略的重要性.
- 除了SPA之外的因素可能会影响相邻部分并发症的风险.
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