| 李战友,丁舒晨,符楚迪,杜江东.腰椎后路减压椎间融合术后融合器退出的危险因素分析[J].浙江中西医结合杂志,2024,34(6): |
| 腰椎后路减压椎间融合术后融合器退出的危险因素分析 |
| Risk factors for cage retropulsion after posterior lumbar interbody fusion |
| 投稿时间：2023-12-27 修订日期：2024-05-06 |
| DOI： |
| 中文关键词: 腰椎 脊柱融合术 手术后并发症 融合器退出 |
| 英文关键词:Lumbar spine Spinal fusion Postoperative complications cage retropulsion |
| 基金项目:杭州市卫生计生科技计划项目(B20200446)、 |
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| 中文摘要: |
| 目的 探讨腰椎后路减压椎间融合内固定术后融合器退出的危险因素。方法 回顾性分析我院2019年1月至2022年1月间行腰椎后路减压椎间融合术的患者资料。将患者的年龄、性别、术前诊断、融合节段数量、终板形态以及是否存在椎间隙上终板后部损伤、骨质疏松、椎弓根螺钉松动视为自变量,并将融合器是否退出及发现融合器退出的时间视为因变量,在单因素生存分析的基础上,建立Cox比例风险回归模型,进行多因素分析。结果 共839例患者纳入研究,其中12例发生融合器退出,发生率1.43%,发现融合器退出的时间平均为术后53.0±19.2天。多因素分析结果显示,间隙上终板后部损伤以及螺钉松动是融合器退出的独立危险因素。结论 融合间隙上终板后部损伤以及椎弓根螺钉松动提高融合器退出风险,术中因避免不规范操作导致上述两种情况,术后发现上述两种情况则因采取相应措施以避免融合器退出。 |
| 英文摘要: |
| 【Abstract】 Objective To investigate the risk factors for cage retropulsion after posterior lumbar interbody fusion. Methods The data of patients who underwent posterior lumbar interbody fusion from January 2019 to January 2022 were retrospectively analyzed. The patient's age, gender, preoperative diagnosis, number of fusion segments, endplate shape, the injury of the posterior part of endplate cranial-adjacent to fusion, osteoporosis, and pedicle screw loosening were regarded as independent variables, and the presence of cage retropulsion and its time were regarded as dependent variables. A Cox proportional risk regression model was established on the basis of univariate survival analysis. Results A total of 839 patients were included in the study, of which 12 patients had cage retropulsion, with an incidence rate of 1.43%, and the average time of cage retropulsion was 53.0±19.2 days after surgery. Multivariate analysis showed that the injury of the posterior part of endplate cranial-adjacent to fusion and screw loosening were independent risk factors for cage retropulsion. Conclusion The injury of the posterior part of endplate cranial-adjacent to fusion and the loosening of the pedicle screw increase the risk of cage retropulsion, and they should be paid more attention either during the surgery or after the surgery. |
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