Cruz Alex, Ropper Alexander E, Xu David S, Bohl Michael, Reece Edward M, Winocour Sebastian J, Buchanan Edward, Kaung Geoffrey
Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, Texas.
Department of Neurosurgery, Baylor College of Medicine, Houston, Texas.
Semin Plast Surg. 2021 Feb;35(1):54-62. doi: 10.1055/s-0041-1726102. Epub 2021 May 10.
Lumbar spinal fusion is a commonly performed procedure to stabilize the spine, and the frequency with which this operation is performed is increasing. Multiple factors are involved in achieving successful arthrodesis. Systemic factors include patient medical comorbidities-such as rheumatoid arthritis and osteoporosis-and smoking status. Surgical site factors include choice of bone graft material, number of fusion levels, location of fusion bed, adequate preparation of fusion site, and biomechanical properties of the fusion construct. Rates of successful fusion can vary from 65 to 100%, depending on the aforementioned factors. Diagnosis of pseudoarthrosis is confirmed by imaging studies, often a combination of static and dynamic radiographs and computed tomography. Once pseudoarthrosis is identified, patient factors should be optimized whenever possible and a surgical plan implemented to provide the best chance of successful revision arthrodesis with the least amount of surgical risk.
腰椎融合术是一种常用的稳定脊柱的手术，且该手术的实施频率正在增加。实现成功的关节融合涉及多个因素。全身因素包括患者的内科合并症，如类风湿性关节炎和骨质疏松症，以及吸烟状况。手术部位因素包括骨移植材料的选择、融合节段的数量、融合床的位置、融合部位的充分准备以及融合结构的生物力学特性。根据上述因素，成功融合的比率在65%至100%之间变化。假关节的诊断通过影像学检查来确认，通常是静态和动态X线片以及计算机断层扫描的组合。一旦确定为假关节，应尽可能优化患者因素，并实施手术计划，以在手术风险最小的情况下提供成功翻修关节融合术的最佳机会。
