下腰椎退变性滑脱手术治疗研究进展
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摘要
治疗退变性腰椎滑脱症的常用术式为PLIF手术,手术节段椎间融合率高,术后患者临床疗效好但相邻椎间盘易退变导致邻椎病,进而影响远期疗效。腰椎不同节段行PLIF术后邻椎病的发生率不同,目前研究结论为L5～S1节段行PLIF术后邻椎病发病率最高。
The common surgical procedure for the treatment of degenerative lumbar spondylolisthesis is PLIF.The rate of intervertebral fusion is high in the surgical segment.The clinical effect of postoperative patients is good,but the adjacent intervertebral disc is easy to degenerate and lead to adjacent spondylosis,which affects the long-term effect.The incidence of adjacent spondylosis in different segments of lumbar vertebrae after PLIF is different.The current study concluds that the incidence of adjacent spondylosis is the highest in PL5-S1 segment after PLIF.
The common surgical procedure for the treatment of degenerative lumbar spondylolisthesis is PLIF.The rate of intervertebral fusion is high in the surgical segment.The clinical effect of postoperative patients is good,but the adjacent intervertebral disc is easy to degenerate and lead to adjacent spondylosis,which affects the long-term effect.The incidence of adjacent spondylosis in different segments of lumbar vertebrae after PLIF is different.The current study concluds that the incidence of adjacent spondylosis is the highest in PL5-S1 segment after PLIF.
引文
[1]黄卫国,海涌.成人腰椎滑脱症复位程度对临床疗效的影响[J].实用骨科杂志,2015,20(4):293-298.
[2] Audat ZM,Darwish FT,AL Barbarawi MM,et a1.Surgical management of low grade isthemic spondylolisthesis:A raft-domized controlled study of the surglcal fixaztion with and without reduction[J].Scoliosis,2011,6(1):14.
[3]刘宏豆.单节段PLIF术治疗退行性腰椎滑脱临床疗效及预后相关因素分析[D].成都中医药大学,2015.
[4]姜欢畅.退变性腰椎滑脱后路融合术后的远期随访研究[D].南方医科大学,2015.
[5]陈之白,周良安,王义生,等.腰椎滑脱症的回顾与治疗新进展[J].中国矫形外科杂志,2006,14(3):167-169.
[6]沈爱东,徐瑞生,包聚良.腰椎滑脱分度的探讨[J].脊柱外科杂志,2010,8(1):49-51.
[7]金朝辉,王春江,龚向峰,等.腰椎滑脱症外科治疗研究及进展[J].包头医学院学报,2010,26(5):138-140.
[8]李栋,尹芸生,郭昊宇.退行性腰椎滑脱的研宄现状和进展[J].中国药物与临床,2009,9:31-33.
[9] Kim KT,Lee SH,Lee YH,et al.Clinical outcomes of 3fusion methods through the posterior approach in the lumbar spine[J].Spine,2006,31(12):1351-1357.
[10] Zhou ZJ,Zhao FD,Fang XQ,et al.Meta-analysis of instrumented posterior interbody fusion versus instrumented posterolateral fusion in the lumbar spine A review[J].Journal of Neurosurgery Spine,2011,15(3):295-310.
[11]阮狄克,何京力,丁宇,等. PLF与PLIF手术治疗腰椎滑脱症的疗效比较[J].中国脊柱脊髓杂志,2004,14(13):156-160.
[12]张占岭.椎弓根螺钉结合椎间植骨融合治疗30例腰椎滑脱症[J].吉林医学,2012,33(5):1006-1007.
[13]郑成胜,姚志喜.后路减压复位固定及椎间融合治疗老年退变性腰椎滑脱[J].当代医学,2013(18):59-60.
[14] ZJ Zhou,FD Zhao,XQ Fang,et al. Meta-analysis of instrumented posterior interbody fusion versus instrumented posterolateral fusion in the lumbar spine[J]. J Neurosurg Spine,2011,1(15):295-310.
[15]林友禧,沈建雄.椎间盘源性腰痛诊治的研究进展[J].中华骨与关节外科杂志,2015,(6):534-537.
[16] Audat Z,Moutasem O,Yousef K,et al.Comparison of clinical and radiological results of posterolateral fusion,posterior lumbar interbody fusion and transforaminal lumbar interbody fusion techniques in the treatment of degenerative lumbar spine[J].Singapore Med J,2012,53(3):183-187.
[17] Lowe TG,Tahernia AD,O’Brien MF,et al.Unilateral transforaminal posterior lumbar interbody fusion(TLIF):Indicatoins,technique,and 2-year results[J].J Spinal Disord,2002,15(3):31-38.
[18] Silvestre C,Mac-Thiong JM,Hilmi R,et al. Complications and morbidities of mini-open anterior retroperitoneal lumbar interbody fusion:Oblique lumbar interbody fusion in 179 patients[J]. Asian Spine J,2012,6(2):89-97.
[19] Mobbs RJ,Phan K,Malham G,et al. Lumbar interbody fusion:Techniques,indications and comparison of interbody fusion options including PLIF,TLIF,MI-TLIF,OLIF/ATP,LLIF and ALIF[J]. J Spine Surg,2015,1(1):2-18.
[20] Woods KR,Billys JB,Hynes RA. Technical description of oblique lateral interbody flusion at L1-L5(OLIF25)and at L5-S1(OLIF51)and evaluation of complication and fusion rates[J]. Spine J,2017,17(4):545-553.
[21] Ohtori S,Mannoji C,Orita S,et al. Mini-open anterior retroperitoneal lumbar interbody fusion:Oblique lateral interbody fusion for degenerated lumbar spinal kyphoscoliosis[J]. Asian Spine J, 2015,9(4):565-572.
[22] Zairi F,Sunna TP,Westwick HJ,et al. Mini open oblique lumbar interbody fusion(OLIF)approach for multi-level dis-cectomy and fusion involving L5-S1:Preliminary experience[J]. Orthop Traumatol Surg Res,2017,103(2):295-299.
[23]张建锋,范顺武,方向前.斜外侧椎间融合术在单节段腰椎间盘退行性疾病中的应用[J].中华骨科杂志,2017,37(2):80-88.
[24]许晓军,薛峰.单节段腰椎融合术治疗腰椎滑脱的疗效及预后分析[J].实用临床医药杂志,2013,17(11):134-135.
[25]郑丁炤.不同腰椎水平融合对邻近节段退变影响的三维有限元研究[D].福建中医学院,2005.
[26]许斌,王与荣,赵建宁,等.脊柱融合内固定术后邻近节段退变研究进展[J].中国矫形外科杂志,2004,12(9):698-699.
[27] Rahm MD,Hall BB. Adjacent-segment degeneration after lumbar fusion with instrumentation:A retrospective study[J]. J Spinal Disord,1996,9(5):392-400.
[28] Aota Y,Kumano K,Hirabayashi S. Postfusion instability at the adjacent segments after rigid pedicle screw fixation for degenerative lumbar spinal disorders[J]. J Spinal Disord,1995,8(6):464-473.
[29] Jae Hwan Cho,MD,Youn-Suk Joo,MD. Effect of one-or two-level posterior lumbar interbody fusion on global sagittal balance[J]. Journal of Spine Surgery,2017,3(1):9.
[2] Audat ZM,Darwish FT,AL Barbarawi MM,et a1.Surgical management of low grade isthemic spondylolisthesis:A raft-domized controlled study of the surglcal fixaztion with and without reduction[J].Scoliosis,2011,6(1):14.
[3]刘宏豆.单节段PLIF术治疗退行性腰椎滑脱临床疗效及预后相关因素分析[D].成都中医药大学,2015.
[4]姜欢畅.退变性腰椎滑脱后路融合术后的远期随访研究[D].南方医科大学,2015.
[5]陈之白,周良安,王义生,等.腰椎滑脱症的回顾与治疗新进展[J].中国矫形外科杂志,2006,14(3):167-169.
[6]沈爱东,徐瑞生,包聚良.腰椎滑脱分度的探讨[J].脊柱外科杂志,2010,8(1):49-51.
[7]金朝辉,王春江,龚向峰,等.腰椎滑脱症外科治疗研究及进展[J].包头医学院学报,2010,26(5):138-140.
[8]李栋,尹芸生,郭昊宇.退行性腰椎滑脱的研宄现状和进展[J].中国药物与临床,2009,9:31-33.
[9] Kim KT,Lee SH,Lee YH,et al.Clinical outcomes of 3fusion methods through the posterior approach in the lumbar spine[J].Spine,2006,31(12):1351-1357.
[10] Zhou ZJ,Zhao FD,Fang XQ,et al.Meta-analysis of instrumented posterior interbody fusion versus instrumented posterolateral fusion in the lumbar spine A review[J].Journal of Neurosurgery Spine,2011,15(3):295-310.
[11]阮狄克,何京力,丁宇,等. PLF与PLIF手术治疗腰椎滑脱症的疗效比较[J].中国脊柱脊髓杂志,2004,14(13):156-160.
[12]张占岭.椎弓根螺钉结合椎间植骨融合治疗30例腰椎滑脱症[J].吉林医学,2012,33(5):1006-1007.
[13]郑成胜,姚志喜.后路减压复位固定及椎间融合治疗老年退变性腰椎滑脱[J].当代医学,2013(18):59-60.
[14] ZJ Zhou,FD Zhao,XQ Fang,et al. Meta-analysis of instrumented posterior interbody fusion versus instrumented posterolateral fusion in the lumbar spine[J]. J Neurosurg Spine,2011,1(15):295-310.
[15]林友禧,沈建雄.椎间盘源性腰痛诊治的研究进展[J].中华骨与关节外科杂志,2015,(6):534-537.
[16] Audat Z,Moutasem O,Yousef K,et al.Comparison of clinical and radiological results of posterolateral fusion,posterior lumbar interbody fusion and transforaminal lumbar interbody fusion techniques in the treatment of degenerative lumbar spine[J].Singapore Med J,2012,53(3):183-187.
[17] Lowe TG,Tahernia AD,O’Brien MF,et al.Unilateral transforaminal posterior lumbar interbody fusion(TLIF):Indicatoins,technique,and 2-year results[J].J Spinal Disord,2002,15(3):31-38.
[18] Silvestre C,Mac-Thiong JM,Hilmi R,et al. Complications and morbidities of mini-open anterior retroperitoneal lumbar interbody fusion:Oblique lumbar interbody fusion in 179 patients[J]. Asian Spine J,2012,6(2):89-97.
[19] Mobbs RJ,Phan K,Malham G,et al. Lumbar interbody fusion:Techniques,indications and comparison of interbody fusion options including PLIF,TLIF,MI-TLIF,OLIF/ATP,LLIF and ALIF[J]. J Spine Surg,2015,1(1):2-18.
[20] Woods KR,Billys JB,Hynes RA. Technical description of oblique lateral interbody flusion at L1-L5(OLIF25)and at L5-S1(OLIF51)and evaluation of complication and fusion rates[J]. Spine J,2017,17(4):545-553.
[21] Ohtori S,Mannoji C,Orita S,et al. Mini-open anterior retroperitoneal lumbar interbody fusion:Oblique lateral interbody fusion for degenerated lumbar spinal kyphoscoliosis[J]. Asian Spine J, 2015,9(4):565-572.
[22] Zairi F,Sunna TP,Westwick HJ,et al. Mini open oblique lumbar interbody fusion(OLIF)approach for multi-level dis-cectomy and fusion involving L5-S1:Preliminary experience[J]. Orthop Traumatol Surg Res,2017,103(2):295-299.
[23]张建锋,范顺武,方向前.斜外侧椎间融合术在单节段腰椎间盘退行性疾病中的应用[J].中华骨科杂志,2017,37(2):80-88.
[24]许晓军,薛峰.单节段腰椎融合术治疗腰椎滑脱的疗效及预后分析[J].实用临床医药杂志,2013,17(11):134-135.
[25]郑丁炤.不同腰椎水平融合对邻近节段退变影响的三维有限元研究[D].福建中医学院,2005.
[26]许斌,王与荣,赵建宁,等.脊柱融合内固定术后邻近节段退变研究进展[J].中国矫形外科杂志,2004,12(9):698-699.
[27] Rahm MD,Hall BB. Adjacent-segment degeneration after lumbar fusion with instrumentation:A retrospective study[J]. J Spinal Disord,1996,9(5):392-400.
[28] Aota Y,Kumano K,Hirabayashi S. Postfusion instability at the adjacent segments after rigid pedicle screw fixation for degenerative lumbar spinal disorders[J]. J Spinal Disord,1995,8(6):464-473.
[29] Jae Hwan Cho,MD,Youn-Suk Joo,MD. Effect of one-or two-level posterior lumbar interbody fusion on global sagittal balance[J]. Journal of Spine Surgery,2017,3(1):9.