摘要
目的分析椎弓根螺钉内固定下腰椎融合手术后腰痛原因。方法随访2001年1月-2003年12月采用椎弓根螺钉内固定下腰椎融合手术103例，男43例，女60例；腰椎滑脱28例，腰椎管狭窄54例，腰椎间盘突出症21例。随访时进行问卷调查及X线、CT或MRI检查，并分析手术后腰痛的可能原因。结果随访时间3—5年，疗效优良80例（77．7％）；术后有咀显腰痛或腰痛伴下肢放射痛23例（22．3％）。邻近节段疾病11例（2节段融合7例，1节段融合4例；10．7％），内固定使用不当3例，椎弓根螺钉断裂2例，减压不完全2例，高位椎间盘突出1例，不明原因4例。结论邻近节段疾病、内固定使用不当、内固定失败是复发性腰痛主要原因。原有退变基础、减压范围超过融合节段、融合节段的长短都是产生邻近节段疾病的重要的危险因素。
Objective To analyze the cause of recurrent back pain and sciatica following lumbar spinal fusion with pedicle screw fixation. Methods From Jan 2001 to Dec 2003, 103 patients underwent lumbar spinal fusion with pedicle screw fixation were reviewed. There were 43 males and 60 females with lumbar spondylolisthesis in 28 patients, spinal stenosis in 54 patients and disc herniation in 21 patients. They were checked by questionnaire, X-ray, CT or Mill at follow-up, and the possible cause of recurrent back pain and sciatica were analyzed. Results All patients were followed up 3 to 5 years, 80 patients had satisfactory results（77.6% ）, while 23 patients（22.3% ） had recurrent back pain and sciatica, which included 11 （ 10.7% ） adjacent segment disease（7 two segement fusion, 4 one segment fusion ）, 3 unsuitable fixation, 2 screw breakage, 2 incomplete decompression, 1 upper disc herniation and 4 uncertain cause. Conclusion adjacent segment disease, unsuitable instrumentation and failure of fixation may be the most important factor of recurrent back pain. original degeneration, over decompression and insufficient fusion may be the important risk factors for adjacent segment diseases.
出处
《脊柱外科杂志》
2007年第4期227-229,234,共4页
Journal of Spinal Surgery
关键词
腰椎
腰痛
内固定器
脊柱融合术
lumbar vertebrae
low back pain
internal fixators
spinal fusion
