在单一水平的腰椎融合之后,长期持续的斜腰失衡
Mitchell Ng1, Joydeep Baidya, Joshua Mathew
1Department of Orthopedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Spine
|February 2, 2026
概括
单层腰部融合可以在6个月内稳定脊骨骨对齐,但大多数患者长期保持不平衡. 在退行性疾病中纠正松性参数的临床重要性需要进一步研究.
科学领域:
- 脊柱手术的结果 脊柱手术的结果
- 脊柱对齐的生物力学分析
- 退行性脊柱疾病管理管理
背景情况:
- 在成年人形手术中,射手平衡至关重要.
- 在单级聚变后,脊皮膜参数的持久性还没有得到很好的定义.
- 在退行性疾病的融合中,沙吉塔平衡的相关性是不确定的.
研究的目的:
- 为了评估单一水平腰部融合后脊骨皮层对齐的长期变化.
- 评估 spinopelvic 参数在融合后的持久性.
- 确定在融合后的斜腰不平衡的流行情况.
主要方法:
- 对413名接受单级腰部融合 (L4-S1) 的成年患者进行了回顾性队列研究.
- 在基线,术后以及6个月,1年和2-3年后的站立横向放射图的分析.
- 测量腰部主病,细分主病,圆盘高度,十字斜率,骨盆倾斜,骨盆发病率和PI-LL不匹配;松不平衡定义为PT>20°或PI-LL>10°.
主要成果:
- 随着时间的推移,Segmental lordosis逐渐减少.
- 腰部主症,圆盘高度,十字斜率和骨盆倾斜显示出最小的变化.
- 患有PI-LL不匹配>10°的患者比例从40.9%降至31.0% (P <0.001).
- 患有PT>20°的患者比例从67.6%降至56.9% (P <0.001).
- 超过一半的患者在最终随访时仍然失衡;年龄较大和更低的水平预测了持续的失衡.
结论:
- 脊椎皮层参数在单层腰部融合后6个月稳定下来,随后有轻微的补偿性改善.
- 很大一部分患者表现出持久的沙吉塔不平衡.
- 在焦点退行性疾病中脊骨皮层参数校正的临床意义仍然不确定.
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