Eck J C, Humphreys S C, Hodges S D
University of Health Sciences, College of Osteopathic Medicine, Kansas City, Missouri, USA.
Am J Orthop (Belle Mead NJ). 1999 Jun;28(6):336-40.
Lumbar fusion is commonly performed to relieve pain from degenerative conditions, including spinal stenosis and spondylolisthesis. While clinical studies have reported favorable fusion rates with limited complications, few have investigated the effect of fusion on the adjacent motion segment. A solid fusion alters the biomechanics at the adjacent level, resulting in increased mechanical demands. There have been reports of increased rates of adjacent-level pathologic lesions after fusion, but these have not accounted for the natural history of degenerative changes. Biomechanical and radiographic studies have shown increased forces, mobility, and intradiscal pressure in adjacent segments after fusion. It has been hypothesized that these changes lead to an acceleration in pathologic changes.
腰椎融合术通常用于缓解退行性疾病引起的疼痛，包括腰椎管狭窄症和腰椎滑脱症。虽然临床研究报告了融合率良好且并发症有限，但很少有研究调查融合对相邻运动节段的影响。坚固的融合会改变相邻节段的生物力学，导致机械需求增加。有报道称融合后相邻节段病理性病变的发生率增加，但这些报道并未考虑退行性变化的自然病程。生物力学和影像学研究表明，融合后相邻节段的力量、活动度和椎间盘内压力增加。据推测，这些变化会导致病理变化加速。
