腰椎间盘置换对腰椎前凸的影响

背景：人工全椎间盘置换是近年来治疗腰背部疼痛可选择的方法之一，但有关置换后对腰椎矢状面影响的报道较少。 目的：分析腰椎间盘置换后对腰椎前凸的影响。 方法：回顾性分析17例曾因单节段退变性椎间盘疾病行腰椎间盘置换的患者影像学资料，数据测量包括置换前及置换后腰椎前凸角、病变节段前凸角、腰骶椎间角。 结果与结论：17例患者随访均12个月以上。行椎间盘置换的患者中L_4-5节段病变3例，L₅-S₁节段病变14例。与椎间盘置换前相比，椎间盘置换后平均病变节段前凸角、腰椎前凸角均显著增加(P < 0.05)；与椎间盘置换前相比，假体置入后腰骶椎间角增加，但差异无显著性意义。结果提示，对于单节段退变性椎间盘疾病腰椎间盘置换后有助于增加患者腰椎前凸和病变节段前凸角度，有助于改善患者腰椎矢状面平衡。置换后腰骶椎间角与置换节段假体置入角度无关。

Lumbar lordosis after lumbar disc replacement

BACKGROUND:Artificial total disc replacement is one treatment of low back pain in recent years, but the report on the effect of disc replacement on lumbar sagittal plane is rare.   OBJECTIVE:To analyze the effect of lumbar disc replacement on lumbar lordosis. METHODS:Retrospective analysis of radiographic data of 17 patients who underwent lumbar disc replacement for single segment degenerative disc disease was carried out. Data measurement included preoperative and postoperative lumbar lordosis, diseased segmental lordosis and lumbar intervertebral angle. RESULTS AND CONCLUSION:All the 17 patients were followed-up for more than 12 months. Lumbar disc replacement was performed at L_4-5 segment in three cases and L₅-S₁ segment in 14 cases. The average diseased segmental lordosis and lumbar lordosis were increased significantly after replacement when compared with those before replacement (P < 0.05); the lumbar intervertebral angle was increased after replacement when compared with that before replacement, but the difference was not significant. The results indicate that lumbar disc replacement for the treatment of single segment degenerative disc disease can increase the lumbar lordosis and diseased segmental lordosis, which can help to improve the lumbar sagittal balance. The postoperative lumbar intervertebral angle has no correlation with the implant angle of the prosthesis on the replace segment.