Nedelea Dana-Georgiana, Vulpe Diana Elena, Dragosloveanu Serban, Stoica Ioan Cristian
Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
Department of Orthopedics, Foisor Clinical Hospital of Orthopedics, Traumatology and Osteoarticular Tuberculosis, Bucharest, Romania.
J Med Life. 2025 Mar;18(3):223-228. doi: 10.25122/jml-2025-0048.
Laminectomy is a widely used surgical approach in patients with spinal canal stenosis but can result in biomechanical changes leading to iatrogenic spondylolisthesis. While some factors, such as surgical technique and achievement of spinal stability, are key contributors, patient-specific factors remain underexplored. Our study included 64 patients with diagnosed iatrogenic spondylolisthesis following previous spinal surgery. They were stratified into male and female groups, and clinical parameters such as the body mass index (BMI), fatty infiltration of the paraspinal muscles (assessed via Goutallier classification), pain scores (Visual Analogue Scale - VAS), and functional outcomes (Oswestry Disability Index - ODI) were analyzed pre-and postoperatively. The cohort consisted of 19 men and 45 women, with a mean age of 63.7 ± 10.82 years. There was a statistically significant difference in BMI, with higher values in women than men (30.16 ± 2.73 vs. 28.11 ± 2.71, = 0.0078). Fatty infiltration of the paraspinal muscles was also more pronounced in women, with significant differences observed in Goutallier grades 2 and 3 ( = 0.007). While no differences were noted in surgery duration or hospital stay, males experienced greater intraoperative blood loss ( = 0.0442). Both groups had similar short- and mid-term pain and functional improvement, with no statistically significant differences in the VAS or ODI scores. In conclusion, patients with iatrogenic spondylolisthesis showed sex-based differences in BMI and fatty infiltration of the paraspinal muscles in patients. These factors did not influence short- and mid-term functional recovery but may play a key role in disease progression and surgical outcomes.
椎板切除术是治疗椎管狭窄患者广泛采用的手术方法,但可能导致生物力学改变,进而引发医源性椎体滑脱。虽然一些因素,如手术技术和脊柱稳定性的实现,是关键因素,但患者个体因素仍未得到充分研究。我们的研究纳入了64例先前脊柱手术后诊断为医源性椎体滑脱的患者。他们被分为男性和女性组,并对术前和术后的临床参数进行了分析,如体重指数(BMI)、椎旁肌脂肪浸润(通过Goutallier分级评估)、疼痛评分(视觉模拟评分法 - VAS)和功能结果(Oswestry功能障碍指数 - ODI)。该队列包括19名男性和45名女性,平均年龄为63.7±10.82岁。BMI存在统计学显著差异,女性的值高于男性(30.16±2.73对28.11±2.71,P = 0.0078)。椎旁肌脂肪浸润在女性中也更明显,在Goutallier 2级和3级观察到显著差异(P = 0.007)。虽然手术时间或住院时间没有差异,但男性术中失血量更多(P = 0.0442)。两组在短期和中期的疼痛及功能改善方面相似,VAS或ODI评分没有统计学显著差异。总之,医源性椎体滑脱患者在BMI和椎旁肌脂肪浸润方面存在性别差异。这些因素不影响短期和中期功能恢复,但可能在疾病进展和手术结果中起关键作用。