[1]王玉,岳斌,张国庆,等.退行性腰椎滑脱稳定性与手术复位率的相关性分析[J].中华老年骨科与康复电子杂志,2016,(04):198-204.[doi:10.3877/cma.j.issn.2096-0263.2016.04.002]
　Wang Yu,Yue Bin,Zhang Guoqing,et al.Correlation analysis between stability of the degenerative lumbar spondylolisthesis and the reduction rate in aged patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(04):198-204.[doi:10.3877/cma.j.issn.2096-0263.2016.04.002]
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退行性腰椎滑脱稳定性与手术复位率的相关性分析()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2016年04期
页码:
198-204
栏目:
脊柱专题
出版日期:
2016-11-05

文章信息/Info

Title:
Correlation analysis between stability of the degenerative lumbar spondylolisthesis and the reduction rate in aged patients
作者:
王玉; 岳斌; 张国庆; 相宏飞; 陈伯华
266000 青岛大学附属医院骨科
Author(s):
Wang Yu;  Yue Bin;  Zhang Guoqing;  Xiang Hongfei;  Chen Bohua
Department of Orthopedics, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
关键词:
腰椎;  椎体滑脱;  老年人;  椎体复位率
Keywords:
Lumbar vertebrae;  Spondylolisthesis;  Aged;  Vertebral reduction rate
DOI:
10.3877/cma.j.issn.2096-0263.2016.04.002
文献标志码:
A
摘要:
目的 探讨退行性腰椎滑脱稳定性与手术复位率的相关性。方法 回顾性分析2013年6月至 2015年 6月青岛大学附属医院行手术治疗并获取完整影像学资料的退行性腰椎滑脱患者 63例，测量腰椎滑脱稳定性（动力位椎体滑移距离差 d、椎体夹角差α）和复位率 r，计算所有患者术前 d、α与 r的相关性。依据术前影像学资料分为腰椎不稳组（n=21）和腰椎稳定组（n=42），随访并比较两组患者术前 d、α、 r及手术前后 VAS和 JOA评分。依据年龄分为＜60岁（n=33）和≥60岁组（n=30），分别比较两组患者腰椎不稳例数及复位率。结果 63 例患者均获得满意随访，随访时间为 6～24 个月，平均（16±7）个月。动力位椎体滑移距离差 d 与复位率 r 呈显著正相关（r=0.592，P=0.001），椎体夹角差α与复位率 r 呈显著正相关（r=0.476，P=0.001）。腰椎不稳组 d（t=8.981，P＜0.05）、α（t=5.343，P＜0.05）、（r Z=2.610， P＜0.05）皆高于腰椎稳定组。＜60岁组腰椎不稳发生率为21.2%，显著低于≥60岁组（46.7%，c2=4.582， P=0.032），＜60岁组 r 为 0.45±0.33，显著低于≥60 岁组（0.61±0.32），差异有统计学意义（Z=2.150， P=0.031）。结论 退行性腰椎滑脱患者不一定伴有腰椎不稳，但超过 60岁的退行性腰椎滑脱患者更易出现同节段腰椎不稳，如患者术前滑脱节段出现腰椎不稳，建议尽可能复位。
Abstract:
Objective To investigate the correlation of degenerative lumbar spondylolisthesis stability and surgical reduction rate. Methods Sixty-three cases of degenerative lumbar spondylolisthesis treated with surgical treatment and complete imaging data were obtained in the Affiliated Hospital of Qingdao University from June 2013 to June 2015. The sagittal translation (d), angulation (α) from extension to flexion film were measured and the reduction rate (r) of each patient were calculated. Correlation between d, α and r in all patients were analyzed. Patients were divided into the lumbar instability group (21 cases) and lumbar stability group (42 cases) according to the imaging criteria of lumbar instability diagnosis. Comparison of the r, d, α, VAS, JOA between two groups were done. Then redivided all patients into 60 years below group (33 cases) and over 60 years group (30 cases). The number of lumbar instability and the reduction rate between two groups were compared. Results Sixty-three cases were followed up for 6 to 24 months with an average of 16±7 m. In all patients, d and r were significantly positive correlated (r=0.592, P=0.001), and significant positive correlation was found between α and r (r=0.476, P=0.001). The d (t=8.981, P<0.05), α (t=5.343, P<0.05) and r (Z=2.610, P<0.05) of the lumbar instability group was significantly higher than the stability group. Patients in over 60 years group sustain a higher incidence of lumbar instability and higher reduction rate (46.7%) compared with below 60 years group (21.2%), and r （0.61 ± 0.32) was lower than the 60 years below group(0.45 ± 0.33), The difference was statistically significant (c2=4.582, P=0.032; Z=2.150, P=0.031). Conclusions Lumbar instability is not an accompanied disease with DLS, but can be commonly found in elderly DLS patients on the lesion segment. Once lumbar instability was discovered before surgery, lumbar reduction was recommended as soon as possiable.

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金（No.81371998）
更新日期/Last Update: 2017-04-01