L5椎体肿瘤后路切除重建内固定术中置入钛网的高度

目的分析L5椎体肿瘤术中置入钛网高度及其相关因素,为L_5椎体肿瘤患者术前预测钛网理想高度提供参考。方法回顾性分析37例L_5椎体肿瘤行后路腰椎肿瘤切除重建内固定术患者的临床资料,包括性别、身高、体质量、脊柱相关节段高度、术中置入钛网的高度。采用Student’s t检验法分别比较压缩性骨折和非压缩形骨折患者置入钛网中轴高度(Ht)与L_4下缘至S1上缘高度(H)的差异,以及压缩性骨折和非压缩性骨折患者间Ht的差异;并利用单因素线性相关分析、多元线性回归分析法进一步筛选影响Ht的因素,并推导选择合适Ht的公式。结果术前存在L5椎体压缩性骨折的患者Ht普遍长于H,无压缩性骨折患者Ht则短于H。身高和L_4/L_5椎间盘高度(H_(L4/L5))是Ht的回归参数,回归方程为Ht(mm)=0.467×身高(cm)+0.628×H_(L4/L5)(mm)-36.215。结论 L_5椎体肿瘤行后路腰椎肿瘤切除重建内固定术中置入钛网的理想高度与患者身高和L_4/L_5椎间盘高度相关。术前存在压缩性骨折的患者术中置入的钛网应适当长于术前L_4下缘至S1上缘距离,而无压缩性骨折患者反之。

Height of titanium Mesh in L5 vertebral tumor resection via posterior approach and reconstruction

Objective To analyze the relationship between the height of the titanium mesh and other factors during the operation of the L₅ vertebral tumor to provide a reference for the prediction of the ideal height of the titanium mesh before operation in the L₅ tumor patients. Methods The clinical data of 37 patients with L₅ vertebral tumors who underwent posterior lumbar tumor resection and reconstruction were retrospectively analyzed,including gender,body height,weight,height of spinal related segments,proper height of the titanium mesh. The difference between the titanium mesh height(H_t) and the distance between L₄ and S₁(H) of patients with or without compression fracture and the difference of H_t between patients with and without compression fracture were analyzed by student''s t test. The factors affecting H_t were screened for deducing the formula to select the proper H_t by single factor linear correlation analysis and multiple linear regression analysis. Results H_t was generally larger than H in patients with preoperative L₅ vertebral compression,while H_t was generally smaller than H in patients without compression fracture. Body height and the height of L₄/L₅ intervertebral disc was regression parameter of H_t. The regression equation is H_t(mm)=0.467×height(cm)+ 0.628×H_L4/L5(mm)-36.215. Conclusion The ideal height of the implanted titanium mesh in the posterior lumbar spinal tumor resection and reconstruction of the L₅ vertebral tumor patients is correlated with the body height and the height of L₄/L₅ intervertebral disc. The implantation of titanium mesh should be longer than the distance between L₄ and S₁ in patients with preoperative compression fractures,while it should be shorter in patients without preoperative compression fracture.