隐性脊柱裂对第五腰椎峡部裂骨愈合的影响。
Effects of Spina Bifida Occulta on Bone Union in Fifth Lumbar Spondylolysis.
作者信息
Gamada Hisanori, Tatsumura Masaki, Okuwaki Shun, Funayama Toru, Yamazaki Masashi
机构信息
Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Department of Orthopedic Surgery and Sports Medicine, Tsukuba University Hospital Mito Clinical Education and Training Center/Mito Kyodo General Hospital, Mito, Japan.
出版信息
Spine Surg Relat Res. 2023 Mar 13;7(4):390-395. doi: 10.22603/ssrr.2022-0255. eCollection 2023 Jul 27.
INTRODUCTION
The effect of spina bifida occulta (SBO) on bone union in lumbar spondylolysis is controversial. The study aim was to assess the effect of SBO on bone union after conservative treatment of L5 spondylolysis, the most common level.
METHODS
The study included 191 lesions in 145 patients (mean age, 14.0 years) with conservatively treated L5 spondylolysis. We examined the relationships between bone union after conservative treatment and the number of SBOs, levels, and single or multilevel status. Fisher's exact probability test, chi-square test, and Welch's T test were performed.
RESULTS
The SBO incidence was 53%, with at least one SBO at any vertebral level. SBO at S1 (=0.034) or S2 (=0.0003), two SBOs (=0.0018), and three SBOs (=0.011) were associated with a lower bone union rate. The bone union rate was significantly lower for lesions with SBOs at both S1 and S2 than without (42% vs. 79%; <0.0001).
CONCLUSIONS
The SBO incidence in L5 spondylolysis was 53%. SBO at S1 or S2 and a higher number of SBOs were associated with lower bone union rates. In particular, the bone union rate of lesions with SBOs at both S1 and S2 was <50%.
引言
隐性脊柱裂（SBO）对腰椎峡部裂骨愈合的影响存在争议。本研究旨在评估SBO对最常见的L5峡部裂保守治疗后骨愈合的影响。
方法
本研究纳入了145例（平均年龄14.0岁）接受L5峡部裂保守治疗的患者的191处病变。我们研究了保守治疗后骨愈合与SBO数量、节段以及单节段或多节段状态之间的关系。进行了Fisher精确概率检验、卡方检验和Welch's T检验。
结果
SBO发生率为53%，在任何椎体节段至少有一处SBO。S1（=0.034）或S2（=0.0003）处的SBO、两处SBO（=0.0018）和三处SBO（=0.011）与较低的骨愈合率相关。S1和S2均有SBO的病变的骨愈合率显著低于无SBO者（42%对79%；<0.0001）。
结论
L5峡部裂中SBO发生率为53%。S1或S2处的SBO以及更多数量的SBO与较低的骨愈合率相关。特别是，S1和S2均有SBO的病变的骨愈合率<50%。
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