[1]张翔,宋文静,孙金星,等.抗骨质疏松治疗预防腰椎滑脱融合术后邻椎病发生的临床研究[J].中国中医骨伤科杂志,2023,31(12):49-52.[doi:10.20085/j.cnki.issn1005-0205.231210]
　ZHANG Xiang,SONG Wenjing,SUN Jinxing,et al.Clinical Study on Prevention of Adjacent Vertebral Disease after Lumbar Spondylolisthesis Fusion with Anti-Osteoporosis Therapy[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(12):49-52.[doi:10.20085/j.cnki.issn1005-0205.231210]
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抗骨质疏松治疗预防腰椎滑脱融合术后邻椎病发生的临床研究()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年12期
页码:
49-52
栏目:
临床研究
出版日期:
2023-12-15

文章信息/Info

Title:
Clinical Study on Prevention of Adjacent Vertebral Disease after Lumbar Spondylolisthesis Fusion with Anti-Osteoporosis Therapy
文章编号:
1005-0205(2023)12-0049-04
作者:
张翔1; 宋文静1; 孙金星1; 王欢1; 申霞1; 侯海涛1△
1山东省文登整骨医院(山东 威海,264400)
Author(s):
ZHANG Xiang1; SONG Wenjing1; SUN Jinxing1; WANG Huan1; SHEN Xia1; HOU Haitao1△
1Shandong Wendeng Osteopathic Hospital,Weihai 264400,Shandong China.
关键词:
腰椎;  脊椎滑脱;  骨质疏松;  脊柱融合术;  邻椎病
Keywords:
lumbar vertebra;  spondylolisthesis;  osteoporosis;  spinal fusion;  adjacent segment degeneration
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.231210
文献标志码:
A
摘要:
目的:对比分析抗骨质疏松治疗对腰椎滑脱融合术后疗效及邻椎病(ASD)发生的预防效果。方法:2018年1月至2021年6月,采用单节段经椎间孔腰椎椎间融合术(TLIF)治疗Ⅱ度以内退行性腰椎滑脱症合并骨质疏松症患者104例,其中52例进行抗骨质疏松治疗(A组),52例为对照组(B组)。记录两组患者治疗前及治疗后3,6,12个月日本骨科学会(JOA)评分及Oswestry功能障碍指数(ODI),评估腰椎功能并记录两组患者术后24个月内发生邻椎病的时间及例数。结果:两组患者术后各随访时间点JOA评分及ODI均较术前明显改善,差异均有统计学意义(P<0.05)。术后3个月,两组患者JOA评分及ODI改善差异无统计学意义(P>0.05); 术后6个月和12个月,A组JOA评分及ODI较B组明显改善,差异有统计学意义(P<0.05)。A组术后24个月内邻椎病出现1例,B组出现5例,但差异无统计学意义(P>0.05)。结论:对于保守治疗效果欠佳的老年退行性腰椎滑脱患者,在围手术期及术后中远期加强抗骨质疏松的治疗,对于术后疼痛症状的改善、脊柱功能的恢复及生活自理能力的提升有较大促进作用,有利于获得更好的长期临床疗效,并且对于术后邻椎病的发生可能起到一定预防作用。
Abstract:
Objective:To compare and analyze the efficacy of anti-osteoporosis treatment on lumbar spondylolisthesis fusion and the prevention effect of adjacent segment degeneration(ASD).Methods:From January 2018 to June 2021,104 patients with degenerative lumbar spondylolisthesis combined with osteoporosis were treated with single-stage transforaminal lumbar interbody fusion(TLIF)of which 52 were treated with anti-osteoporosis therapy(group A)and 52 were treated as control group(group B).The Japanese Orthopaedic Society(JOA)score and Oswestry disability index(ODI)were recorded before treatment and 3,6,and 12 months after treatment in 2 groups to evaluate lumbar function.The occurrence time and number of ASD cases within 24 months after surgery were recorded in both groups.Results:JOA score and ODI were significantly improved at each follow-up time point between the two groups,and the differences were statistically significant(P<0.05).3 months after surgery,there was no significant difference in JOA score and ODI improvement between the two groups(P>0.05).After 6 and 12 months,JOA score and ODI in group A were significantly improved compared with group B,and the difference was statistically significant(P<0.05).There was 1 case of ASD in group A and 5 cases in group B within 24 months after surgery,but the difference was not statistically significant(P>0.05).Conclusion:For elderly patients with degenerative lumbar spondylolisthesis whose conservative treatment is not effective,strengthening anti-osteoporosis treatment in the perioperative period and postoperative medium and long term can greatly promote the improvement of postoperative pain symptoms,the recovery of spinal function,and the improvement of self-care ability,which is conducive to obtaining better long-term clinical efficacy,and the occurrence of postoperative ASD may play a certain preventive role.

参考文献/References:

[1] DE KUNDER S L,VAN KUIJK S,RIJKERS K,et al.Transforaminal lumbar interbody fusion(TLIF)versus posterior lumbar interbody fusion(PLIF)in lumbar spondylolisthesis:a systematic review and meta-analysis[J].Spine J,2017,17(11):1712-1721.
[2] CHANG M C,KIM G U,CHOO Y J,et al.Transforaminal lumbar interbody fusion(TLIF)versus oblique lumbar interbody fusion(OLIF)in interbody fusion technique for degenerative spondylolisthesis:a systematic review and meta-analysis[J].Life(Basel),2021,11(7):696.
[3] 中华医学会骨质疏松和骨矿盐疾病分会.原发性骨质疏松症诊疗指南(2022)[J].中华骨质疏松和骨矿盐疾病杂志,2022,15(6):573-611.
[4] KOSLOSKY E,GENDELBERG D.Classification in brief:the Meyerding classification system of spondylolisthesis[J].Clin Orthop Relat Res,2020,478(5):1125-1130.
[5] 孙金星,申霞,张翔,等.后路腰椎椎间融合术中置入单枚或双枚椎间融合器治疗Ⅱ度退行性腰椎滑脱症[J].脊柱外科杂志,2022,20(6):372-378.
[6] 侯海涛,申霞,张翔,等.微创脊柱融合手术两种辅助置钉方法的对比研究[J].中国中医骨伤科杂志,2022,30(11):38-43.
[7] 李梅,章振林,夏维波.骨质疏松症药物治疗的必由之路:长程序贯治疗[J].中华骨质疏松和骨矿盐疾病杂志,2021,14(5):441-446.
[8] PARK P,GARTON H J,GALA V C,et al.Adjacent segment disease after lumbar or lumbosacral fusion:review of the literature[J].Spine(Phila Pa 1976),2004,29(17):1938-1944.
[9] HILIBRAND A S,ROBBINS M.Adjacent segment degeneration and adjacent segment disease:the consequences of spinal fusion?[J].Spine J,2004,4(6 Suppl):190S-194S.
[10] 顾军,王以进,端木群力,等.山羊腰椎内固定术中椎弓根螺钉植入深度对邻椎的影响[J].中国骨伤,2010,23(11):845-848.
[11] 曹鹏,向刚刚,高启龙,等.腰椎术后邻椎病发生的相关性研究进展[J].中国医学创新,2023,20(11):184-188.
[12] YANG Z,GRIFFITH J F,LEUNG P C,et al.Effect of osteoporosis on morphology and mobility of the lumbar spine[J].Spine(Phila Pa 1976),2009,34(3):E115-E121.
[13] 钟远鸣,苏之盟,覃海飚,等.骨质疏松对后路腰椎椎体间融合术后骨融合的影响[J].中华骨与关节外科杂志,2015,8(6):482-485.
[14] CHIN D K,PARK J Y,YOON Y S,et al.Prevalence of osteoporosis in patients requiring spine surgery:incidence and significance of osteoporosis in spine disease[J].Osteoporos Int,2007,18(9):1219-1224.
[15] BLACK D M,ROSEN C J.Clinical practice:postmenopausal osteoporosis[J].N Engl J Med,2016,374(3):254-262.
[16] 陈定中,杨益,李超艺,等.唑来膦酸联合依降钙素对骨质疏松骨折患者术后骨痛及骨折愈合的影响[J].中国临床药理学杂志,2022,38(16):1863-1867.
[17] 李梅,夏维波,章振林.骨转换生化标志物临床应用指南[J].中华骨质疏松和骨矿盐疾病杂志,2021,14(4):321-336.

备注/Memo

备注/Memo:
△通信作者 E-mail:hhtwdzg@163.com
更新日期/Last Update: 2023-12-10