Risk factors for L5-S1 disk height reduction after lumbar posterolateral floating fusion surgery.
Risk factors for L5-S1 disk height reduction after lumbar posterolateral floating fusion surgery.
复制标题
腰椎后外侧浮动融合手术后 L5-S1 椎间盘高度降低的危险因素。
DOI：
10.1097/bsd.0000000000000088
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发表时间：
2014
影响因子：
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通讯作者：
Ohtori S.
中科院分区：
文献类型：
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作者：
Inoue G;Takaso M;Miyagi M;Kamoda H;Ishikawa T;Nakazawa T;Imura T;Ueno M;Saito W;Uchida K;Toyone T;Takahashi K;Ohtori S.
研究设计：这是一项回顾性研究。目的：探讨腰椎后外侧漂浮融合术后L5-S1椎间盘高度降低的危险因素。背景资料总结：我们调查了从2007年到2010年接受后外侧漂浮融合手术的86例患者（45例男性）的数据。随访时间为2 - 6年。患者平均年龄65.4岁。方法：计算L5-S1椎间盘高度，以> 2 mm复位为显著。最后随访时比较年龄、性别、身高、体重、体重指数、融合节段数、椎间盘退变程度、椎间盘高度和直径、骶腰椎对齐、融合节段对齐、愈合情况和近端相邻节段障碍。进行单因素和多因素logistic回归。结果：L5-S1椎间盘高度降低14例（30.2%）。无椎间盘高度降低的患者融合节段数明显增加（1.8±0.8 vs. 1.4±0.6）。放射学显示无椎间盘高度降低的患者术后L1-S1骶腰椎对线有显著变化（0.3±6.6度vs - 4.5±7.6度）。术前L5-S1椎间盘后盘高度（7.3±2.1 vs 6.1±2.1 mm）明显高于未降低椎间盘高度的患者。在多因素logistic回归分析中，>3节段融合是L5-S1椎间盘高度降低的重要危险因素。结论：在后外侧浮动融合手术中，多节段融合患者L5-S1椎间盘高度降低和随之而来的椎间孔狭窄的风险较高。手术方法和融合水平的选择应考虑其与L5-S1椎间盘高度降低的关系。
Study Design:This is a retrospective study.Objective:To investigate the risk factors for radiographic L5–S1 disk height reduction after lumbar posterolateral floating fusion surgery.Summary of Background Data:We investigated data from 86 patients (45 men) who underwent posterolateral floating fusion surgery from 2007 to 2010. The follow-up was from 2 to 6 years. The mean age of the patients was 65.4 years.Methods:L5–S1 disk height was calculated and> 2 mm reduction was defined as significant. Age, sex, height, weight, body mass index, number of fused levels, grade of disk degeneration, disk height and diameter, sacrolumbar alignment, alignment of fused level, achievement of union, and proximal adjacent segment disorder at final follow-up were compared. Univariate and multivariate logistic regressions were performed.Results:L5–S1 disk height reduction occurred in 14 patients (30.2%). The number of fused levels was significantly greater (1.8±0.8 vs. 1.4±0.6) in patients without disk height reduction. Radiology showed a significant change of L1–S1 sacrolumbar alignment after surgery in patients without disk height reduction (0.3±6.6 vs.–4.5±7.6 degrees). The height of the disk posterior to the L5–S1 intervertebral disk before surgery was significantly greater (7.3±2.1 vs. 6.1±2.1 mm) in patients without disk height reduction. In multivariate logistic regression analysis, fusion of> 3 levels was a significant risk factor for L5–S1 disk height reduction.Conclusions:In posterolateral floating fusion surgery, there was a higher risk of L5–S1 disk height reduction and consequent foraminal stenosis in patients with multiple-level fusion. Surgical methods and fusion levels should be chosen after considering their association with L5–S1 disk height reduction.