Pinto Eduardo Moreira, Teixeria Artur, Frada Richado, Oliveira Filipa, Atilano Pedro, Veigas Tânia, Miranda António
Orthop Rev (Pavia). 2021 Jun 24;13(2):24915. doi: 10.52965/001c.24915. eCollection 2021.
Individual risk factors for the development of adjacent segment pathology (ASP) need to be investigated and identified to address possible modifiable factors in advance and improve outcomes and reduce medical costs. This study aimed to review the literature regarding patient-related risk factors and sagittal alignment parameters associated with ASP development.
The authors performed an extensive review of the literature addressing the objectives mentioned earlier.
Certain patient factors such as age, gender, obesity, preexisting degeneration, osteoporosis, postmenopausal state, rheumatoid arthritis, and facet tropism may contribute to adjacent segment degeneration. Genetic influences, such as polymorphisms of the vitamin D receptor and collagen IX genes, can also be a potential cause for disc degeneration with consequent deterioration of the motion segment.The influence of sagittal imbalances, particularly after lumbar fusion, is a significant parameter to be taken into account as an independent risk factor for ASP development.
Patient-specific risk factors, such as age, gender, obesity, preexisting degeneration, and genetic features increase the likelihood of developing ASP. On the other hand, sagittal alignment plays a significant role in the development of this condition.
需要对相邻节段病变（ASP）发生的个体风险因素进行调查和识别，以便提前应对可能的可改变因素，改善治疗效果并降低医疗成本。本研究旨在回顾与ASP发生相关的患者相关风险因素和矢状面排列参数的文献。
作者对涉及上述目标的文献进行了广泛回顾。
某些患者因素，如年龄、性别、肥胖、既往退变、骨质疏松、绝经后状态、类风湿关节炎和小关节不对称，可能导致相邻节段退变。基因影响，如维生素D受体和IX型胶原基因的多态性，也可能是椎间盘退变进而导致运动节段恶化的潜在原因。矢状面失衡的影响，尤其是腰椎融合术后，作为ASP发生的独立风险因素，是一个需要考虑的重要参数。
特定于患者的风险因素，如年龄、性别、肥胖、既往退变和基因特征，会增加发生ASP的可能性。另一方面，矢状面排列在这种疾病的发生中起重要作用。
