| 完全复位对单节段L4/5退行性腰椎滑脱症的疗效分析 |
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| 作者姓名： | 卢春闻 杜诗尧 王勇 王亮亮 常住 王振伟 许天明 |
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| 作者单位： | 中国人民解放军海军第905医院骨科,中国人民解放军海军第905医院骨科,中国人民解放军海军第905医院骨科,中国人民解放军海军第905医院骨科,中国人民解放军海军第905医院骨科,中国人民解放军海军第905医院骨科,中国人民解放军海军第905医院骨科 |
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| 基金项目： | ] 上海市自然科学基金(22ZR1476600),Supported by Natural Science Foundation of Shanghai (22ZR1476600). |
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| 摘 要： | 目的：研究完全复位对于在腰椎后路椎间融合术治疗单节段L4/5退变性腰椎滑脱症患者的临床疗效及矢状位力线的影响。方法：纳入自2015年1月至2018年1月于我院因L4/5腰椎退变性滑脱行腰椎后路椎间融合术70例患者,分为完全复位与部分复位组。对比分析两组患者术前、术后三月及末次随访时的一般资料、影像学参数及临床疗效指标。结果：共有70例退变性腰椎滑脱症患者纳入本研究,两组各计35例。完全复位组与部分复位组在术中出血量以及手术时间上有显著统计学差异(230.1±67.6 vs. 182.5±56.3 ml, P<0.001; 176.4±35.2 vs. 152.6±23.4 min, P<0.001),且完全复位组的滑脱矫形率显著高于部分复位组(89.5±10.2 vs. 30.5±20.5 %, P<0.001)。两组患者在术后TK、PT、SVA均有减小趋势,LL有增大趋势。术后三月,两组间的SVA具有统计学差异(26.5±21.2 vs. 34.5±24.6 mm, P=0.012)。末次随访时,两组间的LL、PT以及SVA具有统计学差异,且完全复位组小于部分复位组。结论：对于L4/5单节段退变性腰椎滑脱患者而言,无论完全复位抑或是部分复位均能取得较好的临床疗效。较之部分复位,完全复位的患者出血量相对较多,手术时间相对延长,但在远期的临床疗效上收益较好,且能够保证更好的矢状位力线。
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| 关 键 词： | 退变性腰椎滑脱 完全复位 矢状位 临床疗效 |
| 收稿时间： | 2022/6/5 0:00:00 |
| 修稿时间： | 2022/10/20 0:00:00 |
Efficacy of complete reduction on single segment L4/5 degenerative lumbar spondylolisthesis |
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| Authors: | LU Chun-wen DU Shi-yao WANG Yong WANG Liang-liang CHANG Zhu WANG Zhen-wei XU Tian-ming |
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| Affiliation: | Department of Orthopedics,905 naval hospital of the Chinese people''s Liberation Army,Department of Orthopedics,905 naval hospital of the Chinese people''s Liberation Army,Department of Orthopedics,905 naval hospital of the Chinese people''s Liberation Army,Department of Orthopedics,905 naval hospital of the Chinese people''s Liberation Army,Department of Orthopedics,905 naval hospital of the Chinese people''s Liberation Army,Department of Orthopedics,905 naval hospital of the Chinese people''s Liberation Army,Department of Orthopedics,905 naval hospital of the Chinese people''s Liberation Army |
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| Abstract: | Objective To study the effect of complete reduction on the clinical efficacy and sagittal alignment of patients with single segment L4/5 degenerative lumbar spondylolisthesis undergoing posterior lumbar interbody fusion. Methods A total of 70 patients who underwent posterior lumbar interbody fusion for L4/5 lumbar degenerative spondylolisthesis in our hospital from Jan. 2015 to Jan. 2018 were included. They were divided into complete reduction group and partial reduction group, with 35 cases in each group. The general data, operation parameters, radiographical parameters and clinical efficacy of the 2 groups were analyzed. Results There were no significance in gender, age, body mass index, spondylolisthesis degree, or preoperative thoracic kyphosis (TK), lumbar lodorsis (LL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), sagittal vertical axis (SVA), visual analogue scale (VAS) score, or Oswestry disability index (ODI) score between the 2 groups (all P>0.05). Compared with the partial reduction group, the complete reduction group had more intraoperative blood loss (230.1±67.6] mL vs182.5±56.3] mL), longer operative time (176.4±35.2] min vs152.6±23.4] min), and higher correction rate (89.5±10.2]% vs30.5±20.5]%) (all P<0.001). Compared with those before operation, TK, PT and SVA in the 2 groups were decreased, while LL was increased. At 3 months after operation, SVA in the complete reduction group was smaller than that in the partial reduction group (26.5±21.2] mm vs34.5±24.6] mm, P=0.012). At the last follow-up, LL, PT and SVA in the complete reduction group were smaller than those in the partial reduction group (45.3±5.9] ° vs48.2±6.3] °,16.4±6.8] ° vs18.3±7.1] °,26.8±23.2] mm vs36.5±26.2] mm, all P<0.05); and the VAS and ODI scores in the complete reduction group were lower than those in the partial reduction group (1.2±0.5 vs 2.2±0.8, 14.5±4.5 vs 20.9±6.4, both P<0.05). Conclusion As for patients with L4/5 single segment degenerative lumbar spondylolisthesis, either complete reduction or partial reduction can achieve better clinical efficacy. Compared with partial reduction, patients with complete reduction have more blood loss and longer operative time, but they have better long-term clinical efficacy and can restore a better sagittal profile. |
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| Keywords: | degenerative lumbar spondylolisthesis complete reduction sagittal profile clinical efficacy |
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