腰椎内固定术后顽固下腰痛原因分析.pdfVIP

腰椎内固定术后顽固下腰痛原因分析 袁建军 1 阚世廉 2 贾宇涛 3 刘洋 1 田融 1 (1 天津医科大学研究生院 天津市人民医院 300070 ，2 天津医院 300211 ，3 天津市人民医 院 300121) 作者简介：袁建军（ 1973-），男，天津人，副主任医师，博士在读，研究方向：脊柱外 科， （电话），,，（电子信箱） 摘要 目的：分析腰椎柔韧性及关节突关节退变程度对腰椎内固定术后下腰痛缓 解率的影响。方法：随访 100 例行腰 4,5 单节段内固定术患者，术前测量前屈、 后伸位腰椎前凸角度的变化作为腰椎柔韧性指标，测量腰 3,4 关节突关节角，并 进行退变程度分级，术前和术后 1 年对病人进行 Oswestry 评分，并计算改善率。 分析腰椎柔韧性及关节突关节退变对术后下腰痛改善率的影响。 结果：腰椎柔韧 性与手术后症状改善率呈正相关。 关节突关节退变严重组术后症状改善率差， 关 节突关节角不对称组术后改善率较差。 结论：腰椎柔韧性、 关节突关节角对称性 和关节突关节退变程度是影响腰椎内固定术后下腰痛改善率的重要因素， 可为判 断临床预后提供参考。 关键词：腰椎 内固定术 柔韧性 关节突关节 改善率 The analysis of the causes of obstinate low back pian after lumbar internal fixation. YUAN Jian-jun,KAN Shi-lian,JIA Yu-tao(Graduate School of Tianjin Medical of Spinal Surgery, People’s Hospital of Tianjin,Tianjin 300121,China) Abstract objective: to investigate the effection of the lumbar flexibility, lumbar facet joint angle, facet joint degeneration on improvement rate of low back pain after lumbar internal fixation. method: 100 cases which undergone lumbar internal fixation of L4,L5 were followed up, facet joint angle of L3,4 was measured, degeneration of facet joint was graded, lumbar lordosis angle at extension and flexion position was measured aspectely, Oswestry score was obtained before and 1 year after operation. results:Lumbar flexibility is positively correlated with the improvement rate of low back pain,the patients with severe degeneration of the facet joint and asymmetry facet joint angle have a bad improvement rate. Conclusion: lumbar flexibility 、lumbar facet joint degeneration and facet joint symmetry are important factors which influence the outcome of lumbar i