[1]侯海涛 邵诗泽 付松.应力滑移率在峡部裂型腰椎滑脱症治疗中应用的中期随访[J].中国中医骨伤科杂志,2016,24(04):26-29.
　HOU Haitao SHAO Shize FU Song.Clinical Outcomes of Evaluating the Treatment of Spondylolisthesis in Lumbar Spondylolysis by Stress Slippage Rate:A Midterm Follow-up[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2016,24(04):26-29.
点击复制

应力滑移率在峡部裂型腰椎滑脱症治疗中应用的中期随访
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第24卷
期数:
2016年04期
页码:
26-29
栏目:
临床研究
出版日期:
2016-04-15

文章信息/Info

Title:
Clinical Outcomes of Evaluating the Treatment of Spondylolisthesis in Lumbar Spondylolysis by Stress Slippage Rate:A Midterm Follow-up
文章编号:
1005-0205(2016)04-0026-04
作者:
侯海涛1 邵诗泽1 付松1
1.山东省文登整骨医院(山东 文登,264400)
Author(s):
HOU Haitao1 SHAO Shize1 FU Song1
1.Shandong Wendeng Orthopedic Hospital,Wendeng 264400,Shandong China.
关键词:
应力滑移率;  峡部裂;  腰椎滑脱
Keywords:
stress slippage rate;  anterior slippage rate;  spondylolisthesis
分类号:
R681.5
文献标志码:
A
摘要:
目的:通过中期有效随访,探讨应力滑移率(Stress Slippage Rate,SSR)在峡部裂型腰椎滑脱症治疗中应用的价值。方法:回顾性分析2008年9月至2014年5月在本院治疗的179例峡部裂型腰椎滑脱症患者,依据SSR的不同程度进行分组,Ⅰ组SSR≥30%,Ⅱ组30%>SSR≥25%,Ⅲ组SSR<25%.应用单因素方差分析三组患者治疗前的JOA(Japanese Orthopaedic Association)评分是否具有统计学差异; 应用Pearson相关分析对应力滑移率(SSR)、向前滑移率(ASR)与JOA评分的相关性进行对比,分析影响JOA评分的相关因素; 采用Pearson偏相关分析对SSR,ASR与手术复位率(ORR)的相关性进行对比,分析影响术中滑脱椎体复位难易程度的因素; 分别对三组患者治疗前后JOA评分、SSR值改变行t检验,评价差异是否具有统计学意义。结果:三组患者治疗前的JOA评分差异具有统计学意义(F=6.441,P=0.028),行两两之间LSD发现各组间JOA评分差异均具有统计学意义(P<0.01)。ASR,SSR与治疗前JOA评分具有负相关性,其中ASR(r=-0.219,P=0.017),SSR(r=-0.534,P<0.01)。ORR与SRR呈明显的正相关(r=0.697,P=0.01),差异有统计学意义,而ORR与ASR之间不具有相关性(r=-0.024,P=0.872)。Ⅰ组、Ⅲ组治疗前后JOA评分差异均有统计学意义(P<0.01),Ⅱ组差异无统计学意义(P=0.71)。Ⅰ组、Ⅲ组治疗前后SSR值差异均有统计学意义(P<0.01),Ⅱ组差异无统计学意义(P=0.11)。结论:应力滑移率(SSR)不但是评价峡部裂型腰椎滑脱症椎间稳定性的一项有效指标,而且对于不同程度患者的治疗方案的选择以及术中及术后复位效果的评估都具有重要的指导意义。
Abstract:
Objective:The goal of the study was to evaluate midterm clinical results of using stress slippage rate(SSR)in the treatment of spondylolisthesis in lumbar spondylolysis.Methods:We identified 179 patients at an average follow-up of 35.4 months from September 2008 to May 2014.According to the stress slippage rate,all patients were divided into 3 groups:group I(SSR≥30%),group Ⅱ(30%>SSR≥25%)and group Ⅲ(SSR<25%).JOA(Japanese Orthopedic Association)scores of three groups were compared using one-way analysis of variance before treatment.The correlations between SSR and JOA score,ASR(anterior slippage rate)and JOA score were analyzed by Pearson correlation analysis.The correlations between SSR and ORR(operative reduction rate),ASR and ORR were analyzed by Pearson correlation analysis.According to the above results,we analyzed influential factors of the reduction of spondylolisthesis.JOA scores and SSRs were compared before and post treatment in each group by t-test.Results:There were statistically significant differences among the JOA scores of patients in the three groups before treatment(F=6.441,P=0.028).There were also statistically significant difference between each pair of JOA scores(P<0.01)before treatment.ASR was negatively correlated with the JOA score before treatment(r=-0.219,P=0.017),as well as between SSR and JOA score(r=-0.534,P<0.01).There was significant positive correlation of ORR and SRR(r=0.697,P=0.01),however,there was no correlation between ASR and ORR(r=-0.024,P=0.872).There were statistically significant differences of JOA scores in group I and Ⅲ before and post treatment(P<0.01),as well as SSR(P<0.01).There were no significant differences of JOA scores and SSR in group Ⅱ before and post treatment(P=0.71,P=0.11).Conclusions:Stress slippage rate could be used as an evaluation indicator for intervertebral stability of spondylolisthesis in lumbar spondylolysis before and post treatment.Long-term follow-up is necessary to define the optimal application of SSR.

参考文献/References:

[1] Wittenberg RH.Comment on “Posterior reduction and anterior lumbar interbody fusion in symptomatic low-grade adult isthmic spondylolisthesis:short-term radiological and functional outcome” by P.G.Anderson et al[J].Eur Spine J,2002,11(5):434.
[2] 谭远超,张卫,张恩忠,等.应力滑移率对腰椎峡部裂并滑脱症的诊疗价值[J].中华骨科杂志,2008,28(2):145-148.
[3] Boxall D,Bradford DS,Winter RB,et al.Management of severe spondylolisthesis in children and adolescents[J].J Bone Joint Surg Am,1979,61(4):479-495.
[4] 傅士儒.运动员腰椎峡部裂的原因和预防[J].中华骨科杂志,1987,16(8):401-404.
[5] Young KJ,Koning W.Spondylolysis of L2 in identical twins[J].J Manipulative Physiol Ther,2003,26(3):196-201.
[6] Blackburne JS,Velikas EP.Spondylolisthesis in children and adolescents[J].J Bone Joint Surg Br,1977,59-B(4):490-494.
[7] Frennered AK,Danielson BI,Nachemson AL.Natural history of symptomatic isthmic low-grade spondylolisthesis in children and adolescents:a seven-year follow-up study[J].J Pediatr Orthop,1991,11(2):209-213.
[8] 代飞,刘瑶瑶,孙东,等.新型可注射骨水泥椎弓根螺钉与骨水泥钉道强化在治疗腰椎滑脱伴骨质疏松中的比较研究[J].脊柱外科杂志,2014,12(5):257-261.
[9] 李端明,彭宝淦,杨洪,等.退变性腰椎滑脱症的手术治疗[J].脊柱外科杂志,2011,9(4):207-210.
[10] Marchi L,Oliveira L,Coutinho E,et al.Results and complications after 2-level axial lumbar interbody fusion with a minimum 2-year follow-up[J].J Neurosurg Spine,2012,17(3):187-192.
[11] Shin MH,Ryu KS,Rathi NK,et al.Direct pars repair surgery using two different surgical methods:pedicle screw with universal hook system and direct pars screw fixation in symptomatic lumbar spondylosis patients[J].Journal of Korean Neurosurgical Society,2012,51(1):14-19.
[12] 陈鹏,朱国兴,杨玉生,等.后路椎弓根钉复位固定加自体减压椎板骨粒超大量植骨治疗腰椎滑脱[J].中华创伤杂志,2013,29(8):753-755.

备注/Memo

备注/Memo:
收稿日期:2015-10-01
更新日期/Last Update: 2016-04-15