中国中西医结合影像学杂志
中國中西醫結閤影像學雜誌
중국중서의결합영상학잡지
CHINESE IMAGING JOURNAL OF INTEGRATED TRADITIONAL AND WESTERN MEDICINE
2015年
1期
19-22
,共4页
脊柱融合术%椎间盘退化%比例危险度模型
脊柱融閤術%椎間盤退化%比例危險度模型
척주융합술%추간반퇴화%비례위험도모형
Spinal fusion%Intervertebral disk degeneration%Proportional hazards models
目的：探讨腰椎融合术后邻近节段退化（adjacent segment deterioration,ASDet）的危险因素及相对风险度，以求降低患者术后发生ASDet的风险。方法：选择山东中医药大学附属医院2010年9月至2014年7月行腰椎融合手术患者136例。应用MRI评估患者术前椎间盘退变情况，应用Cox比例风险回归模型分析腰椎融合术后ASDet的发生与年龄、性别、骨质疏松、术前邻近节段椎间盘退变、椎板减压术、融合节段数、椎间隙撑开、使用内固定、腰骶椎融合等9个因素的相关性和风险性。结果：术前椎间盘退变（RR=4.272，P<0.01）和椎间隙撑开（RR=2.022，P=0.024）与术后ASDet的发生呈显著相关。结论：术前椎间盘退变及术中行椎间隙撑开可增加术后发生ASDet的风险。
目的：探討腰椎融閤術後鄰近節段退化（adjacent segment deterioration,ASDet）的危險因素及相對風險度，以求降低患者術後髮生ASDet的風險。方法：選擇山東中醫藥大學附屬醫院2010年9月至2014年7月行腰椎融閤手術患者136例。應用MRI評估患者術前椎間盤退變情況，應用Cox比例風險迴歸模型分析腰椎融閤術後ASDet的髮生與年齡、性彆、骨質疏鬆、術前鄰近節段椎間盤退變、椎闆減壓術、融閤節段數、椎間隙撐開、使用內固定、腰骶椎融閤等9箇因素的相關性和風險性。結果：術前椎間盤退變（RR=4.272，P<0.01）和椎間隙撐開（RR=2.022，P=0.024）與術後ASDet的髮生呈顯著相關。結論：術前椎間盤退變及術中行椎間隙撐開可增加術後髮生ASDet的風險。
목적：탐토요추융합술후린근절단퇴화（adjacent segment deterioration,ASDet）적위험인소급상대풍험도，이구강저환자술후발생ASDet적풍험。방법：선택산동중의약대학부속의원2010년9월지2014년7월행요추융합수술환자136례。응용MRI평고환자술전추간반퇴변정황，응용Cox비례풍험회귀모형분석요추융합술후ASDet적발생여년령、성별、골질소송、술전린근절단추간반퇴변、추판감압술、융합절단수、추간극탱개、사용내고정、요저추융합등9개인소적상관성화풍험성。결과：술전추간반퇴변（RR=4.272，P<0.01）화추간극탱개（RR=2.022，P=0.024）여술후ASDet적발생정현저상관。결론：술전추간반퇴변급술중행추간극탱개가증가술후발생ASDet적풍험。
Objective:To investigate the risk factors and the relative degree of postoperative occurrence of adjacent segment de-terioration (ASDet) after lumbar fusion. To reduce the occurrence of ASDet,improve the clinical efficacy of surgical treatment of lumbar fusion. Methods:136 cases who had been performed lumbar fusion were selected. All cases underwent MRI for eva-luating intervertebral disc degeneration. Cox proportional hazards regression model was used to analyze the correlation and the relative risk degree from the occurrence of ASDet and 9 related factors which included age,sex,osteoporosis,intervertebral disc degeneration,laminectomy,range of lumbar fusion,intervertebral disc space distraction,internal fixation,lumbosacral fusion. Result:Multivariate Cox regression analysis showed that intervertebral disc degeneration (RR=4.272,P=0.000) and intervertebral disc space distraction (RR=2.022,P=0.024) were significant correlated with the occurrence of ASDet. Conclusion:To choose operation reas-onably for the patients with intervertebral disc degeneration and not to distract the intervertebral disc space overmuch could re-duce the occurrence of ASDet.
