中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (52): 9782-9786.doi: 10.3969/j.issn.1673-8225.2011.52.022

• 骨与关节图像与影像 bone and joint imaging • 上一篇    下一篇

腰椎融合后邻近节段影像学评估方法的应用随访

吴  超1，魏  剑1，王  清2，谭  伦1，黄  迅1，唐玉湖1   

  1. 1四川省自贡市第四人民医院骨科，四川省自贡市  643000
    2 泸州医学院附属医院脊柱外科，四川省泸州市  646000
  • 收稿日期:2011-06-19 修回日期:2011-07-20 出版日期:2011-12-24 发布日期:2011-12-24
  • 通讯作者: 王清，硕士，主任医师，教授，硕士生导师，泸州医学院附属医院脊柱外科，四川省泸州市646000 wqspine2004@163.com
  • 作者简介:吴超★，男，1977年生，四川省自贡市人，汉族，2011年泸州医学院毕业，硕士，主治医师，主要从事脊柱外科与创伤研究。 flightiness@163.com
  • 基金资助:

    四川省卫生厅科学研究项目(080424)。

Follow-up application of imaging evaluation on adjacent lumbar segment after instrumented posterior spinal fusion

Wu Chao1, Wei Jian1, Wang Qing2, Tan Lun1, Huang Xun1, Tang Yu-hu1   

  1. 1Department of Orthopedics, the Fourth People’s Hospital, Zigong  643000, Sichuan Province, China
    2Department of Spine Surgery, Affiliated Hospital of Luzhou Medical College, Luzhou  646000, Sichuan Province, China
  • Received:2011-06-19 Revised:2011-07-20 Online:2011-12-24 Published:2011-12-24
  • Contact: Wang Qing, Master, Chief physician, Professor, Master’s supervisor, Department of Spine Surgery, Affiliated Hospital of Luzhou Medical College, Luzhou 646000, Sichuan Province, China wqspine2004@163.com
  • About author:Wu Chao★, Master, Attending physician, Department of Orthopedics, the Fourth People’s Hospital, Zigong 643000, Sichuan Province, China flightiness@163.com
  • Supported by:

    Research Project of Sichuan Provincial Health Department, No. 080424*

PDF

387

被引次数

2

摘要：

背景：目前多数研究只分析了脊柱融合治疗紧邻融合区域头尾侧节段的术后改变，未对其他紧邻内固定的未作融合节段进行对照研究。
目的：探讨腰椎邻近节段的测量方法，对腰椎后外侧融合后邻近节段的改变进行长期随访影像学评估。
方法：选取尸体骨架6具，以不同投照方式和标本位置行腰椎侧位数字化标准X射线片共计42次(每具标本投照7次)。随访57例腰椎后外侧融合患者，随访时间1.5~4年，拍摄融合前及末次随访时的数字化标准X射线片，所有资料用失真代偿X射线分析法测量椎体间矢状角度、椎间盘高度、椎体间前后移位。
结果与结论：失真代偿X射线分析法测量邻近节段矢状曲度、椎间盘高度、椎体间前后移位时，不同投照方式比较差异均无显著性意义(P > 0.05)。固定节段尾侧椎体间未发现显著的影像学改变，固定节段头侧的多个椎体间矢状角度、椎间盘高度均有明显的改变。提示腰椎后外侧融合后影像学的改变提示固定节段头侧多个椎间盘加速退变。

关键词: 腰椎, 融合, 邻近节段, 退行性改变, X射线片

Abstract:

BACKGROUND: Now, most studies related to adjacent segment degeneration only analyze the changes of motion segments above and below the fusion. There were no controlled studies on adjacent segments to all the other unfused segments after instrumented posterior fusion.
OBJECTIVE: To study measurement of adjacent lumbar segments and evaluate long-term radiographic changes in all adjacent lumbar segments after instrumented posterolateral lumbar fusion.
METHODS: Totally 42 digitized radiographs of lateral lumbar spine from 6 corpse skeletons were obtain through different projections and specimen postures (every specimen with 7 projection). Fifty-seven patients with posterolateral lumbar fusion were followed-up from 1.5 to 4 years. Digitized radiographs of them were photographed before fusion surgery and final follow-up. Distortion-compensated roentgen analysis (DCRA) method was used to measure sagittal angle, disc height, and dorsoventral displacement in all the above data.
RESULTS AND CONCLUSION: There were no statistical significance in sagittal angle, disc height, and dorsoventral displacement under different postures by using DCRA method (P > 0.05). No changes were observed at the segments located below the fusion. All the unfused segments above the fusion showed significant changes of sagittal angle and disc height. It is indicated that the radiographic changes of posterolateral lumbar fusion suggest the disc degeneration of the segments above the fusion.

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