L4~5后路椎体间融合治疗后早期腰椎前凸角度的变化

背景：统计后路椎体间融合治疗后早期腰椎前凸角度变化、分析其变化的特点对腰椎间盘突出的治疗具有重要的临床意义。 目的：分析L4~5后路椎体间融合后早期腰椎前凸角度变化及其临床意义。 方法：对L4~5腰椎间盘突出并椎管狭窄症和L4滑脱经后路椎体间融合治疗的116例患者,测量患者治疗前后的腰椎前凸角度。随访资料完整患者40例,L4~5椎间盘突出并椎管狭窄28例,L4腰椎滑脱12例,随访12~24个月,分析治疗前后骶骨倾斜角变化。 结果与结论：治疗后腰椎前凸角度均较治疗前增大(P < 0.05)。腰椎管狭窄与腰椎滑脱患者腰椎前凸角度因手术变化的趋势是相同的(P > 0.05)。治疗前后MacNab评分优和良中的患者腰椎前凸角度比较,差异无显著性意义(P > 0.05)。说明后路椎体间融合是治疗腰椎间盘突出并椎管狭窄症及腰椎滑脱症的有效手段之一。关键词：后路椎体间融合;腰椎前凸角度;腰椎间盘突出;椎管狭窄;腰椎滑脱 doi:10.3969/j.issn.1673-8225.2012.17.012

Changes of lumbar lordosis angle at the early stage after L4-5 posterior lumbar interbody fusion operation

BACKGROUND: It is important to observe the changes of the early lumbar lordosis angle in posterior lumbar interbody fusion (PLIF) treatment, and to analyze the clinical significance of these changes on the treatment of lumbar disc. OBJECTIVE: To analyze the variation of lumbar lordosis angle and its clinical significance on the early postoperative of PLIF at L4-5. METHODS: 116 patients who had undergone the surgery of PLIF were selected. They were suffering from lumbar disc herniation with stenosis disease at L4-5 or suffering from lumbar spondylolisthesis at L4. Then we measured the patients’ lumbar lordosis angle before and after operation. Forty cases had integrated follow-up information, 28 cases were suffering from lumbar disc herniation and stenosis disease at L4-5, 12 cases were suffering from lumbar spondylolisthesis at L4. Statistics of the variation of sacral inclination angle between preoperative and postoperative was analyzed during 12- 24 months follow-up. RESULTS AND CONCLUSION: The lumbar lordosis angles preoperatien were significantly larger than those postoperation (P < 0.05). Undergoing the operation, the changing trend of lumbar lordosis angle between the lumbar spinal canal stenosis group and lumbar disc herniation group was roughly the same (P > 0.05). Before and after the surgery, the difference of lumbar lordosis angle of optimal MacNab score patients and medium and bad MacNab score patients had no statistical significance (P > 0.05). PLIF was proved to be one of the effective methods to treat the lumbar disc herniation with stenosis disease and lumbar spondylolisthesis.