Liu Ze-zheng, Zhang Zhong-min, Jin Da-di
Department of Orthopedic Surgery, Third Affiliated Hospital, Southern Medical University, Guangzhou 510630, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2010 May;30(5):1134-7.
To analyze the factors affecting the occurrence of adjacent segment degeneration (ASD) after lumbar internal fixation.
The clinical data of 147 surgical patients with lumbar disc herniation, lumbar spinal stenosis and lumbar spodylolisthesis undergoing surgeries between January 2002 and July 2007 in our hospital were reviewed. The correlations of gender, range of fixation, position of fixation, and characteristic of the adjacent disc to the occurrence of ASD were analyzed.
The patients were followed up for a mean of 30-/+10 months (18-84 months). The incidence of ASD was 13.6% in these patients, occurring all at the cephalad adjacent segment. The presence of preoperative degeneration of the adjacent disc gave rise to increased risk of ASD following the surgery (chi(2)=6.272, P=0.012), and multivariate analysis indicated that preoperative adjacent disc degeneration was a risk factor for postoperative ASD (P=0.046), but gender, range of fusion and site of fusion were not the risk factors.
Presence of adjacent segment degeneration before the operation is associated with a significantly increased risk of postoperative ASD.
分析腰椎内固定术后影响相邻节段退变（ASD）发生的因素。
回顾性分析2002年1月至2007年7月在我院接受手术治疗的147例腰椎间盘突出症、腰椎管狭窄症和腰椎滑脱症手术患者的临床资料。分析性别、固定范围、固定位置以及相邻椎间盘特征与ASD发生的相关性。
患者平均随访30±10个月（18 - 84个月）。这些患者中ASD的发生率为13.6%，均发生在头侧相邻节段。术前相邻椎间盘退变会增加术后ASD的风险（χ² = 6.272，P = 0.012），多因素分析表明术前相邻椎间盘退变是术后ASD的危险因素（P = 0.046），但性别、融合范围和融合部位不是危险因素。
术前存在相邻节段退变与术后ASD风险显著增加相关。
