Hasday C A, Passoff T L, Perry J
Spine (Phila Pa 1976). 1983 Jul-Aug;8(5):501-11. doi: 10.1097/00007632-198307000-00007.
Six patients with lumbar fractures were studied at the Pathokinesiology laboratory at Rancho Los Amigos Hospital following posterior Harrington distraction instrumentation to identify changes in posture and gait associated with iatrogenic loss of lumbar lordosis. Three patients, all with painful rods, were treated with standard Harrington instrumentation and full length fusion. Three patients were treated with so-called "rodded long-fused short" procedures. It was thought that rod removal in the latter group would result in restoration of lumbar lordosis with concomitant improvement in posture and gait when compared to the full length fusion group. No significant difference between the two groups was found. Rod removal often resulted in kyphotic collapse at the previous fracture site despite solid posterior arthrodesis with net decrease in lumbar lordosis. Hip hyperextension, when available, was the favored compensatory mechanism for loss of lumbar lordosis. Otherwise, hip flexion and forward lean of the trunk was seen.
在兰乔洛斯阿米戈斯医院的病理运动学实验室对6例腰椎骨折患者进行了研究，这些患者在接受后路哈灵顿撑开内固定术后，以确定与医源性腰椎前凸丧失相关的姿势和步态变化。3例患者均有疼痛的棒材，接受了标准的哈灵顿内固定和全长融合治疗。3例患者接受了所谓的“棒材长融合短”手术。据认为，与全长融合组相比，后一组取出棒材将导致腰椎前凸恢复，同时姿势和步态得到改善。两组之间未发现显著差异。尽管后路关节固定牢固且腰椎前凸净减少，但取出棒材常导致先前骨折部位后凸塌陷。当有条件时，髋关节过度伸展是腰椎前凸丧失的首选代偿机制。否则，会出现髋关节屈曲和躯干前倾。
