椎弓根钉椎板钩系统治疗腰椎峡部裂术后对相邻脊柱运动单位的作用.pdfVIP

提 要 目的：探讨相邻节段退变的影响因素及对腰椎运动单位的影响。 方法：对山东中医药大学附属医院脊柱骨科2009年9月至 2011年9月收治的腰 椎峡部裂患者的临床资料进行回顾性分析，从中选取 20 例病例，按手术方式的不同 分为 A、B 两组，分别为椎弓根钉椎板钩内固定加峡部植骨术组和椎弓根钉内固定加 椎间植骨融合术组，对术前术后两组患者的椎间盘退变等级、腰椎前凸角及过伸过屈 位前凸角差值、VAS评分和JOA评分进行统计学分析。 结果：20 例患者经过 1 年和 2 年的术后随访，两组患者的 VAS 评分和 JOA 评分 均显著改变，表示术后效果良好，A 组患者的间盘退变程度较 B 组轻，A 组患者的腰 椎前凸角改变及过伸过屈位前凸角差值改变较B组小。 结论：B组患者退变情况较A组显著，椎弓根钉椎板钩内固定加峡部植骨术后对 患者的腰椎前凸角和间盘影响较小，前凸角的改变和间盘的退变会加速运动单位的改 变，在正确选择手术适应症的情况下，椎弓根钉椎板钩内固定加峡部植骨术操作简单， 手术时间短，是一种行之有效、对脊柱运动单位影响较小的手术方式。 关键词 椎弓峡部裂；腰椎前凸角；相邻节段退变；脊柱运动单位； The Influence on Adjacent Functional Spinal Unit after bone grafting and pedicle screw-lamina hook fixation Speciality：Orthopedics of TCM Author ：Duan xiuyang Tutor： Prof. Xu Zhanwang Abstract Objective: To discuss the influence factor of the functional spinal unit and the influence factor of adjacent segment disease. Methods: 20 patients were treated with complete clinical data of lumbar spondylolysis were retrospectively analyzed from September 2009 to September 2011 。 Relevant literature were reviewed, clinical and imaging findings were summarized,VAS score, JOA score preoperative and postoperative were compared and analyzed . Results: 20 patients were followed up by 1 or 2 years, The VAS score were reduced significantly while the JOA score were improved after the treatment, account for the surgery is effective. The transform of lumbar lordosis angle and the regression of intervertebral disc is significant different. Conclusion: The lumbar lordosis angle and the regression of interv- ertebral disc have an important effect on functional spinal unit . After choosing the right operation indications, good operation effect could be showed after the