腰椎椎体间融合术患者临床和功能结果中的脊柱骨盆参数-一项前瞻性研究

IF 0.1 Q4 SURGERY
Renata Marques, Ana Cristina Silva, João Nogueira, Miguel Afonso, Nubélio Duarte
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引用次数: 0

摘要

摘要目的在长脊柱融合术中,脊柱骨盆参数与患者临床和功能预后的相关性已被广泛研究。然而,脊柱骨盆参数在短节段融合手术中的重要性需要进一步研究。我们分析了短节段腰椎椎体间融合术患者的脊柱骨盆参数和手术结果。材料与方法一项观察性前瞻性研究于2021年1月至6月进行。我们选择了25例腰椎管狭窄,伴或不伴腰椎滑脱的患者,接受经椎间孔腰椎体间融合术。收集与患者、诊断和手术相关的变量。临床和功能结果采用腰痛和腿部疼痛视觉模拟量表和Oswestry残疾指数(ODI)进行评估。分析术前、术后手术效果及脊柱骨盆参数。结果术后患者临床及功能均有显著改善(p <0.001),平均ODI下降63.6%。肥胖、伴椎体滑脱、未行截骨术和两节段融合等变量均与术后较低的改善水平相关(p <0.05)。盆腔发生率减去腰椎前凸(PI-LL)是唯一在术前和术后有显著变化的参数(p <0.05)。术前PI-LL <−10°与术后腰痛减轻相关(r = 0.435;p & lt;0.05)。术后,手术结果与分析的所有脊柱骨盆参数无相关性。结论手术干预可显著改善患者的临床和功能,但与脊柱骨盆参数的变化无关。术前PI-LL和lt患者;−10°的患者似乎从手术中获益最多,背部疼痛得到了更大的改善。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Spinopelvic Parameters in the Clinical and Functional Outcomes of Patients Submitted to Lumbar Interbody Fusion Surgery – A Prospective Study
Abstract Objectives The relevance of spinopelvic parameters in the patients' clinical and functional outcomes has been widely studied in long spinal fusion. Yet, the importance of the spinopelvic parameters in short-segment fusion surgeries needs further investigation. We analyzed the spinopelvic parameters and surgical outcomes of patients undergoing short-segment lumbar interbody fusion. Materials and Methods An observational, prospective study was conducted between January and June 2021. We selected 25 patients with lumbar stenosis, with or without concomitant spondylolisthesis, undergoing transforaminal lumbar interbody fusion. Variables related to the patient, diagnosis, and surgery were collected. The clinical and functional outcomes were assessed using the Visual Analogue Scale for low-back and leg pain and the Oswestry Disability Index (ODI). The surgical outcomes and spinopelvic parameters were analyzed pre- and postoperatively. Results There was a significant clinical and functional improvement after surgery (p < 0.001), with a mean ODI decrease of 63.6%. The variables of obesity, concomitant spondylolisthesis, absence of osteotomy, and two-level fusion were all associated with lower levels of improvement after surgery (p < 0.05). Pelvic incidence minus lumbar lordosis (PI-LL) was the only parameter that significantly changed regarding the pre- and postoperative periods (p < 0.05). Before surgery, PI-LL < −10° correlates with less low-back pain after surgery (r = 0.435; p < 0.05). Postoperatively, no correlation was found between surgical outcomes and all the spinopelvic parameters analyzed. Conclusions The clinical and functional outcomes significantly improved with the surgical intervention but did not correlate with the change in spinopelvic parameters. Patients with preoperative PI-LL < −10° seem to benefit the most from surgery, showing greater improvement in back pain.
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CiteScore
0.20
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68
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