摘要
目的 探讨术前脊柱矢状位失衡对侧路腰椎椎体间融合术(LLIF)术后症状改善的影响.方法 选择2018年1月至2020年12月在该院接受LLIF的86例患者资料进行回顾性分析,根据术前矢状面轴向距离(sagittal vertical axis,SVA)将患者分为A组(SVA≥50 mm)和B组(SVA＜50 mm).观察两组患者临床资料、放射学参数[T2～S1的冠状位Cobb角、SVA、腰椎前凸角(LL)、T5～T12的胸椎后凸角(TK)、骨盆入射角(PI)、骨盆倾斜角(PT)、骶骨倾斜角(SS)和PI-LL]和临床症状改善情况.结果 术前,A组SVA、冠状位Cobb角(CR Cobb角)、PI-LL高于B组,LL低于B组,差异均有统计学意义(P＜0.05);两组患者TK、PI、PT、SS差异均无统计学意义(P＞0.05).A组患者术后1年SVA和PI-LL高于B组,LL低于B组,差异均有统计学意义(P＜0.05);A组患者ΔSVA、ΔLL、ΔPI-LL(Δ表示术后1年与术前的变化值)均高于B组,差异均有统计学意义(P＜0.05).术后1年两组患者腰痛、腿痛、腿麻木VAS评分均较术前显著降低(P＜0.05),两组患者术后1年时的TK、PI、PT、SS及ΔTK、ΔPI、ΔPT和ΔSS差异均无统计学意义(P＞0.05).结论 LLIF手术对患者SVA的恢复效果有限,但可改善患者的临床症状.
Abstract
;Objective To investigate the effect of preoperative sagittal spinal imbalance on postoperative symptom improvement af-ter lateral lumbar interbody fusion(LLIF).Methods The data of 86 patients with LLIF in our hospital from January 2018 to Decem-ber 2020 were retrospectively analyzed.The patients were divided into group A(high SVA Group)and group B(low SVA Group)ac-cording to SVA by SPSS hierarchical cluster analysis program.The clinical data,radiological parameters[coronal Cobb angle of T2-S1,sagittal axial distance(SVA),lumbar lordosis(LL),thoracic kyphosis(TK)of T5-12,pelvic incidence angle(PI),pelvic tilt angle(PT),sacral inclination angle(SS)and PI-LL]and the improvement of clinical symptoms were observed.Results SVA,CR Cobb angle and PI-LL in group A were higher than those in group B,while LL was lower than that in group B(P＜0.05).There was no significant difference in TK,PI,Pt and SS between the two groups(P＞0.05).One year after operation,SVA and PI-LL in group A were higher than those in group B,and LL was lower than that in group B(P＜0.05),and there were significant differences inΔSVA,ΔLL and ΔPI-LL between the two groups(P＜0.05).One year after operation,the VAS scores of low back pain,leg pain and leg numbness in the two groups were significantly lower than those before operation(P＜0.05).There was no significant difference in TK,PI,Pt,SS,ΔTK,ΔPI,ΔPT and ΔSS between the two groups one year after operation(P＞0.05).Conclusion LLIF surgery has limited effect on the recovery of SVA,but it can improve the clinical symptoms of patients.
维普
万方数据