腰椎管狭窄症患者经椎间孔腰椎椎体间融合术后放射学和功能效果的综合评估

Rahul Kumar Singh, Chhewang Topgia, Priyank Deepak
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摘要

目的:腰椎是肌肉骨骼系统的重要组成部分,其结构支撑和活动能力不可或缺。以椎管狭窄为特征的腰椎管狭窄症(LCS)是与退行性病变相关的一个日益严重的问题。经椎间孔腰椎椎体间融合术(TLIF)已成为治疗腰椎管狭窄症的一种手术干预措施,旨在实现减压和稳定。本研究全面评估了腰椎间盘突出症患者接受经椎间孔腰椎椎体融合术(TLIF)后的放射学和功能效果。方法:研究对象是在英迪拉-甘地医学院接受TLIF手术的40名LCS患者。其中 15 例为回顾性评估,于 2016 年 5 月前手术,25 例为前瞻性评估,于 2016 年 5 月至 2017 年 5 月间手术。研究分析了人口统计学数据、术前ASIA评分、黄韧带肥厚、面关节关节病和布里德维尔融合分级。统计检验包括平均值计算、卡方检验和曼-惠特尼U检验。结果研究显示,男性明显占多数(57.5%),年龄分布为 32 至 72 岁,男女比例为 1.35:1(P 值为 0.0049)。术前ASIA评分显示,50%的患者为ASIA D级,25%为E级。70%的患者存在黄韧带肥厚,67.5%的患者存在面关节病。布里德维尔融合等级显示,80%的患者达到了1级融合。结论本研究为 LCS 患者的 TLIF 效果提供了宝贵的见解,强调了年龄、性别、神经状况和相关病变的重要性。良好的融合效果表明,TLIF 能有效稳定腰椎。未来对更大群体的研究可进一步验证这些发现,并完善 TLIF 在腰椎间盘突出症治疗中的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
COMPREHENSIVE ASSESSMENT OF RADIOLOGICAL AND FUNCTIONAL OUTCOMES FOLLOWING TRANSFORAMINAL LUMBAR INTERBODY FUSION IN LUMBAR CANAL STENOSIS PATIENTS
Objective: The lumbar spine, a crucial component of the musculoskeletal system, is integral for structural support and mobility. Lumbar canal stenosis (LCS), characterized by spinal canal narrowing, is a growing concern associated with degenerative changes. Transforaminal lumbar interbody fusion (TLIF) has emerged as a surgical intervention for LCS, aiming to achieve decompression and stabilization. This study comprehensively assesses the radiological and functional outcomes post-TLIF in LCS patients. Methods: A cohort of 40 LCS patients undergoing TLIF at Indira Gandhi Medical College was studied. Fifteen were retrospectively assessed operated on before May 2016, and 25 were prospective, operated between May 2016 and May 2017. Demographic data, preoperative ASIA scores, ligamentum flavum hypertrophy, facet joint arthropathy, and Bridwell Fusion Grades were analyzed. Statistical tests included mean calculations, chi-square tests, and Mann-Whitney U tests. Results: The study revealed a significant male predominance (57.5%) and age distribution (32 to 72 y) with a male-to-female ratio of 1.35:1 (p value 0.0049). Preoperative ASIA scores showed 50% ASIA grade D and 25% grade E. Ligamentum flavum hypertrophy and facet joint arthropathy were present in 70% and 67.5% of patients, respectively. Bridwell Fusion Grade indicated 80% achieved grade 1 fusion. Conclusion: This study contributes valuable insights into TLIF outcomes in LCS patients, emphasizing the significance of age, gender, neurological status, and associated pathologies. Favorable fusion outcomes suggest TLIF effectively stabilizes the lumbar spine. Future research with larger cohorts could further validate these findings and refine TLIF's role in LCS management.
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