摘要
背景:越来越多的研究认为腰椎-骨盆参数与腰椎融合术后的临床效果以及邻近节段退变密切相关,但微创经椎间孔椎间融合对腰椎-骨盆参数的影响并不明确。目的:评价微创经椎间孔椎间融合对单节段腰椎管狭窄症患者腰椎-骨盆影像学参数的影响。方法:回顾性分析2015年1月至2017年1月于大理大学第一附属医院就诊,采用经椎间孔椎间融合治疗的85例单节段腰椎管狭窄症患者的临床资料,其中行微创经椎间孔椎间融合手术39例(微创组),行开放经椎间孔椎间融合手术46例(开放组)。在包含双侧股骨头的站立腰椎侧位X射线片上,测量所有患者术前及末次随访时的腰椎前凸角、节段前凸角、椎间高度、l1中垂线与S1后上角的距离、骨盆入射角、骨盆倾斜角、骶骨倾斜角,并计算骨盆入射角与腰椎前凸角的差值及腰椎前凸角与骨盆入射角的比值。结果与结论:①末次随访时,两组的腰椎前凸角、椎间高度、骶骨倾斜角均较术前增大,而骨盆倾斜角较术前减小,差异均有显著性意义(P<0.05);两组末次随访时的腰椎前凸角、节段前凸角、椎间高度、骨盆入射角、骨盆倾斜角、骶骨倾斜角、l1中垂线与S1后上角的距离相比,差异均无显著性意义(P>0.05);②末次随访时,两组的腰椎前凸角、节段前凸角、椎间高度、骨盆入射角、骨盆倾斜角、骶骨倾斜角、l1中垂线与S1后上角的距离与术前对应参数的差值相比,差异均无显著性意义(P>0.05);③两组的骨盆入射角与腰椎前凸角差值在末次随访时均较术前明显减小,差异有显著性意义(P<0.05);两组的腰椎前凸角与骨盆入射角比值在末次随访时均较术前增大,其中开放组变化显著(P<0.05);但骨盆入射角与腰椎前凸角差值及腰椎前凸角与骨盆入射角比值两组间比较,差异均无显著性意义(P>0.05);④提示对于单节段腰椎椎管狭窄症,与开放经椎间孔椎
BACKGROUND:More and more studies have shown that lumbar-pelvic parameters are closely related to the clinical effect and adjacent segment degeneration after lumbar fusion,but the effect of minimally invasive transforaminal interbody fusion on lumbar-pelvic parameters is not clear.OBJECTIVE:To evaluate the effect of minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)on the lumbar-pelvic imaging parameters in patients with single-segment lumbar spinal stenosis.METHODS:The clinical data of 85 patients with single-segment lumbar spinal stenosis treated by MIS-TLIF and open-TLIF in the First Affiliated Hospital of Dali University from January 2015 to January 2017 were retrospectively analyzed,including 39 cases of MIS-TLIF operation(MIS-TLIF group)and 46 cases of openTLIF operation(open-TLIF group).On the standing lateral lumbar X-ray containing bilateral femoral heads:lumbar lordosis,segmental lordosis,height of the intervertebral disc,the L1 axis and S1 distance,pelvic incidence,pelvic tilt,and sacral slope were measured,and the difference between pelvic incidence-lumbar lordosis and the ratio of lumbar lordosis/pelvic incidence were calculated.RESULTS AND CONCLUSION:(1)During the last follow-up,lumbar lordosis,height of the intervertebral disc,and sacral slope were increased in both groups compared with preoperative parameters,but pelvic tilt was decreased compared with preoperatively,and the difference was significant(P<0.05).Lumbar lordosis,segmental lordosis,height of the intervertebral disc,pelvic incidence,pelvic tilt,sacral slope and the L1 axis and S1 distance were not significantly different between the two groups during the last follow-up(P>0.05).(2)During the last follow-up,lumbar lordosis,segmental lordosis,height of the intervertebral disc,pelvic incidence,pelvic tilt,sacral slope,and the L1 axis and S1 distance were not significantly different compared with preoperative parameters(P>0.05).(3)The difference between pelvic incidence-lumbar lordosis was significantly decreased at the last
作者
姚汝斌
王仕永
杨开舜
Yao Rubin;Wang Shiyong;Yang Kaishun(Department of Spinal Surgery,the First Affiliated Hospital of Dali University,Dali 671000,Yunnan Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第9期1387-1392,共6页
Chinese Journal of Tissue Engineering Research
关键词
腰椎
腰椎管狭窄
骨盆
微创
经椎间孔椎间融合
单节段
lumbar spine
lumbar spinal stenosis
pelvis
minimally invasive
transforaminal lumbar interbody fusion
single segment
