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老年患者经椎弓根腰椎融合术

[Transpedicular lumbar spondylodesis in elderly patients].

作者信息

Rompe J D, Eysel P, Hopf C, Heine J

机构信息

Orthopädische Universitäts- und Poliklinik Mainz.

出版信息

Z Orthop Ihre Grenzgeb. 1995 May-Jun;133(3):249-55. doi: 10.1055/s-2008-1039445.

Abstract

70 patients older than 50 years (mean age: 60.2 years) underwent a CD-spondylodesis from 1987 to 1991 for degenerative changes of the lumbar spine, and were followed for 2 years. 88.2% improved, but only 47.1% showed a good-to-excellent result. Patients with fair and poor outcomes had had significantly more operations on the lumbar spine (p < 0.001), had a greater extent of preoperative lumbar kyphosis (p < 0.05), motor weakness (p < 0.05), had less vertebral slips (p < 0.01), had less posterior distraction postoperatively (p < 0.001), and had a greater extent of postoperative motor weakness compared to patients with good-to-excellent outcomes. Age, sex, duration of back/leg pain, taking of analgetic drugs, preoperative pain status, profession, range of walking, time of operation, number of fused segments, blood loss, blood transfusion, postoperative profile of the spine did not show any significant influence upon clinical results. Already at 6-months-follow-up there was significant difference of the clinical outcome (p < 0.001), making improvement of a then fair or poor result unlikely.

摘要

1987年至1991年间,70例年龄超过50岁(平均年龄:60.2岁)的患者因腰椎退行性变接受了颈椎融合术,并进行了2年的随访。88.2%的患者病情有所改善,但只有47.1%的患者显示出良好至优秀的结果。预后一般和较差的患者腰椎手术次数明显更多(p < 0.001),术前腰椎后凸程度更大(p < 0.05),存在运动无力(p < 0.05),椎体滑脱较少(p < 0.01),术后后路撑开较少(p < 0.001),与预后良好至优秀的患者相比,术后运动无力程度更大。年龄、性别、腰/腿痛持续时间、服用镇痛药情况、术前疼痛状态、职业、行走距离、手术时间、融合节段数、失血量、输血情况、术后脊柱形态对临床结果均无显著影响。在6个月的随访时,临床结果就已存在显著差异(p < 0.001),使得当时预后一般或较差的结果难以改善。

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