Konieczny Markus R, Mokhaberi Shejda, Krauspe Rüdiger
Department of Orthopedic Surgery, University Hospital of Duesseldorf, Germany.
Orthop Rev (Pavia). 2019 Jun 26;11(3):7781. doi: 10.4081/or.2019.7781. eCollection 2019 Sep 24.
We investigated if applying the Transition system (Globus Medical Inc., Audubon, PA, USA) as topping off can prevent Adjacent Segment Degeneration (ASD) and if rate of ASD is increased if instrumentation stopped at the apex of the Lumbar Lordosis (LL). We enrolled 99 consecutive patients in a retrospective study who have been operated by instrumented fusion of the lumbar spine. Thirty patients were treated by topping of (Group 1), 69 patients received the standard procedure (Group 2). 18 patients of group 1 (60%) and 38 patients of group 2 (55%) developed ASD. The difference was not significant (P>0.05). In 17 patients (17%) instrumentation stopped at apex of LL. 14/17 patients (82%) developed an ASD. This influence was significant (P<0.05). Instrumented fusion of the lumbar spine should not stop at the apex of the lumbar curve. Topping off by hybrid dynamic fixation does not reduce the rate of ASD.
我们研究了应用过渡系统（美国宾夕法尼亚州奥杜邦市的Globus Medical公司）作为补充固定是否能预防相邻节段退变（ASD），以及如果在腰椎前凸（LL）顶点处停止内固定，ASD发生率是否会增加。我们对99例连续接受腰椎器械融合手术的患者进行了一项回顾性研究。30例患者采用补充固定治疗（第1组），69例患者接受标准手术（第2组）。第1组18例患者（60%）和第2组38例患者（55%）发生了ASD。差异无统计学意义（P>0.05）。17例患者（17%）的内固定在LL顶点处停止。14/17例患者（82%）发生了ASD。这种影响具有统计学意义（P<0.05）。腰椎器械融合不应在腰椎曲线顶点处停止。采用混合动态固定进行补充固定并不能降低ASD发生率。
