[Modic改变对腰椎椎间融合的影响及其治疗措施的研究进展]
[Research progress on the influence of Modic changes on lumbar interbody fusion and its treatment measure].
作者信息
Xiao Yang, Yang Xi
机构信息
Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China.
出版信息
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Aug 15;37(8):1026-1030. doi: 10.7507/1002-1892.202302007.
OBJECTIVE
To review the research progress of Modic changes and its influence on lumbar interbody fusion.
METHODS
The domestic and foreign literature related to Modic changes and its influence on lumbar interbody fusion was extensively reviewed. The etiology of Modic changes was summarized, and the treatment measures of Modic changes on lumbar interbody fusion were discussed.
RESULTS
The etiology of Modic changes is not clear, which may be related to mechanical factors, autoimmune factors, low toxic infection factors, and genetic factors. Modic changes may lead to fusion failure and cage subsidence after lumbar interbody fusion. Preoperative evaluation of endplate sclerosis, reduction of iatrogenic endplate injury, fine operating of intervertebral space, management of osteoporosis, and selection of appropriate cage can prevent or reduce fusion failure or cage subsidence.
CONCLUSION
Modic changes may lead to fusion failure and cage subsidence after lumbar interbody fusion, and active perioperative intervention of Modic changes is helpful to improve the clinical prognosis.
目的
综述Modic改变的研究进展及其对腰椎椎间融合的影响。
方法
广泛查阅国内外有关Modic改变及其对腰椎椎间融合影响的文献。总结Modic改变的病因，并探讨针对Modic改变对腰椎椎间融合的治疗措施。
结果
Modic改变的病因尚不明确，可能与机械因素、自身免疫因素、低毒感染因素及遗传因素有关。Modic改变可能导致腰椎椎间融合术后融合失败及椎间融合器下沉。术前评估终板硬化情况、减少医源性终板损伤、精细操作椎间隙、处理骨质疏松以及选择合适的椎间融合器可预防或减少融合失败或椎间融合器下沉。
结论
Modic改变可能导致腰椎椎间融合术后融合失败及椎间融合器下沉，围手术期对Modic改变进行积极干预有助于改善临床预后。
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