中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2015年
13期
965-968
,共4页
荚龙%曾至立%于研%吴洋春%程黎明
莢龍%曾至立%于研%吳洋春%程黎明
협룡%증지립%우연%오양춘%정려명
脊柱融合术%腰椎%脊柱损伤%骨钉%椎弓根
脊柱融閤術%腰椎%脊柱損傷%骨釘%椎弓根
척주융합술%요추%척주손상%골정%추궁근
Spinal fusion%Lumbar vertebrae%Bone nail%Spinal injuries%Pedicle
目的 探讨经椎间孔腰椎椎间融合术(TLIF)中椎弓根螺钉对关节突关节影响因素.方法 回顾性分析2011年12月至2013年12月上海同济大学附属同济医院脊柱外科经保守治疗无效后行TLIF手术治疗的101例腰椎退行性疾病患者资料,根据Seo分类法利用CT影像学检查分析融合节段邻近上位椎体椎弓根螺钉与关节突关节的位置关系,检测性别、年龄、邻近上位椎体节段、融合数量、置钉方位与椎弓根螺钉损伤关节突关节的关联性.结果 TLIF手术中邻近上位椎体椎弓根螺钉与关节突关节位置关系:0级:154(76.2％);1级:43(21.3％);2级:5(2.5％),其中L5出现椎弓根螺钉损伤关节突关节较其他椎体节段多见(P＜0.05),左侧出现椎弓根螺损伤关节突关节较右侧常见(P＜0.05),而性别、年龄、融合数量与椎弓根螺钉损伤关节突关节无明显相关性.结论 TLIF手术中邻近上位椎体椎弓根螺钉损伤关节突关节的发生率较高,在左侧椎弓根置入椎弓根螺钉及L5置入椎弓根螺钉时需格外注意.
目的 探討經椎間孔腰椎椎間融閤術(TLIF)中椎弓根螺釘對關節突關節影響因素.方法 迴顧性分析2011年12月至2013年12月上海同濟大學附屬同濟醫院脊柱外科經保守治療無效後行TLIF手術治療的101例腰椎退行性疾病患者資料,根據Seo分類法利用CT影像學檢查分析融閤節段鄰近上位椎體椎弓根螺釘與關節突關節的位置關繫,檢測性彆、年齡、鄰近上位椎體節段、融閤數量、置釘方位與椎弓根螺釘損傷關節突關節的關聯性.結果 TLIF手術中鄰近上位椎體椎弓根螺釘與關節突關節位置關繫:0級:154(76.2％);1級:43(21.3％);2級:5(2.5％),其中L5齣現椎弓根螺釘損傷關節突關節較其他椎體節段多見(P＜0.05),左側齣現椎弓根螺損傷關節突關節較右側常見(P＜0.05),而性彆、年齡、融閤數量與椎弓根螺釘損傷關節突關節無明顯相關性.結論 TLIF手術中鄰近上位椎體椎弓根螺釘損傷關節突關節的髮生率較高,在左側椎弓根置入椎弓根螺釘及L5置入椎弓根螺釘時需格外註意.
목적 탐토경추간공요추추간융합술(TLIF)중추궁근라정대관절돌관절영향인소.방법 회고성분석2011년12월지2013년12월상해동제대학부속동제의원척주외과경보수치료무효후행TLIF수술치료적101례요추퇴행성질병환자자료,근거Seo분류법이용CT영상학검사분석융합절단린근상위추체추궁근라정여관절돌관절적위치관계,검측성별、년령、린근상위추체절단、융합수량、치정방위여추궁근라정손상관절돌관절적관련성.결과 TLIF수술중린근상위추체추궁근라정여관절돌관절위치관계:0급:154(76.2％);1급:43(21.3％);2급:5(2.5％),기중L5출현추궁근라정손상관절돌관절교기타추체절단다견(P＜0.05),좌측출현추궁근라손상관절돌관절교우측상견(P＜0.05),이성별、년령、융합수량여추궁근라정손상관절돌관절무명현상관성.결론 TLIF수술중린근상위추체추궁근라정손상관절돌관절적발생솔교고,재좌측추궁근치입추궁근라정급L5치입추궁근라정시수격외주의.
Objective To explore the influencing factors of pedicle screw instrumentation and provide theoretical rationales for decreasing facet joint violation rate by radiological evaluations of superiorsegment facet joint violation after pedicle screw instrumentation in transforaminal lumbar interbody fusion (TLIF).Methods A retrospective study was conducted for 101 patients undergoing lumbar fusion after failed conservative treatment between December 2011 and December 2013.According to the Seo classification,computed tomography was used for evaluating the position of pedicle screw with superior segment facet joint.And x2 test was used to examine the associations between superior segment facet joint violation and gender,age,construct level,fusion length and transpedicular screw side.Results A total of 202 screws were evaluated.There were grade 0 (n =154,76.2％),grade 1(n =43,21.3％) and grade 2 (n =5,2.5％).In all screws,facet joint violation occurred in L5 segment more frequently than in any other segment (P ＜ 0.05),left-side facet joint violation was more common than right-side one (P ＜ 0.05).No statistical associations existed between violation rates and gender,age and fusion length.Conclusion During TLIF,there is a higher incidence of facet joint violation at right side and in L5 segment compared with other lumbar segments.
