在单级I级退行性脊髓缩的解压后,脊椎间过程固定与后腰间体融合:一项回顾性倾向得分匹配研究
Jingbo Ma1,2, Tusheng Li1,3, Nan Shen1
1Orthopedics of TCM Senior Department, The Sixth Medical Center of People's Liberation Army General Hospital, Beijing, 100048, China.
Journal of orthopaedic surgery and research
|January 31, 2026
概括
脊柱间过程固定 (ISPF) 为退行性腰椎脊柱狭窄症提供了比后腰椎体融合 (PLIF) 更好的短期恢复和斜腰对齐. 然而,这两种方法都提供了类似的长期结果,指导了个性化治疗决策.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 退行性腰椎脊柱狭窄症 退行性腰椎脊柱狭窄症
- 脊髓溶解体的发生.
背景情况:
- 退行性腰椎脊柱狭窄症 (LSS) 与I级脊柱松症的治疗具有挑战性.
- 脊柱间过程固定 (ISPF) 和后腰间体融合 (PLIF) 是外科选择.
- 对比他们的临床和放射性结果对于患者管理至关重要.
研究的目的:
- 为了比较ISPF和PLIF之间的临床结果和放射性参数.
- 为了评估单级退行性LSS与Meyerding I级脊髓缩的疗效.
- 为了告知个性化手术决策.
主要方法:
- 对接受ISPF (n=55) 或PLIF (n=52) 的107名患者的回顾性分析.
- 倾向分数匹配 (PSM) 创建了36个匹配的对.
- 在24个月内评估了临床结果 (VAS,ODI,JOA,Macnab) 和放射性参数 (LL,PI,PT,SA,DH).
主要成果:
- 与PLIF相比,ISPF在VAS和ODI得分方面显示出优异的短期改善.
- 在放射学上,ISPF保持了更好的腰部位 (LL) 和下骨盆倾斜 (PT).
- 在两种手术中,PLIF实现了更大的滑动角度 (SA) 校正,长期结果和患者满意度相似.
结论:
- ISPF提供了增强的短期临床康复和腰对齐维护.
- PLIF提供了优越的纠正脊髓解质滑动.
- 无论是ISPF还是PLIF,都表现出类似的长期疗效,支持针对I级脊髓缩性退行性LSS的量身定制治疗选择.
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