摘要
[目的]探讨肥胖对退行性腰椎管狭窄症(degenerative lumbar spinal stenosis,DLSS)后路椎间融合术(posterior lum-bar interbody fusion,PLIF)的影响.[方法]回顾性分析2017年1月—2019年12月行PLIF治疗的124例DLSS患者,依据术前患者BMI分为两组,其中肥胖组(BMI≥28.0 kg/m^(2))42例,非肥胖组(BMI<28 kg/m^(2))82例,比较两组围手术期、随访及影像资料.[结果]两组患者均顺利完成手术.非肥胖组患者手术时间、切口长度、术中出血量、术后引流量、术后下地时间、切口愈合时间、切口并发症发生率均显著优于肥胖组(P<0.05).患者均获得16~25个月随访,平均随访时间(19.58±2.71)个月,随时间推移,两组患者VAS评分、ODI指数均显著降低(P<0.05).但相应时间点两组间VAS评分、ODI指数差异均无统计学意义(P>0.05).影像学方面,与术前相比,术后3个月及末次随访时两组患者椎间隙高度均显著增加(P<0.05).至末次随访时,两组椎间融合BSF分级差异无统计学意义(P>0.05),但肥胖组邻椎退变率高于非肥胖组(16.67%vs 4.88%,P<0.05).[结论]肥胖增加了DLSS患者PLIF治疗的术中出血量、切口并发症发生率及邻椎退变风险.
[Objective]To explore the effect of obesity on posterior lumbar interbody fusion(PLIF)for degenerative lumbar spinal stenosis(DLSS).[Methods]A retrospective study was conducted on a total of 124 patients who underwent PLIF for DLSS in our hospital from January 2017 to December 2019.According to the preoperative BMI,42 patients who had BMI≥28.0 kg/m^(2) were fall into the obese group,while the remained 82 patients who had BMI<28 kg/m^(2) were enrolled into the non-obese group.The documents regarding to perioperative period,follow-up and radiographs were compared between the two groups.[Results]All patients had operation completed successfully.The non-obese group was significantly superior to the obese group in terms of operation time,incision length,intraoperative blood loss,postoperative drainage,time to resume walking,time to remove stitches and incidence of incision complications(P<0.05).All patients were followed up for 16~25 months,with an average of(19.58±2.71)months.The VAS score and ODI index of the two groups were significantly im-proved over time.However,there was no significant difference in VAS score and ODI index between the two groups at any corresponding time point(P>0.05).With respect of imaging,the disc height significantly increased at the last follow-up and 3 months after operation in both groups compared with those before operation(P<0.05).At the last follow-up,there was no significant difference in interbody fusion in term of BSF classification between the two groups(P>0.05),but the degeneration rate of adjacent vertebrae in the obese group was higher than that in the non-obese group(16.67%vs 4.88%,P<0.05).[Conclusion]Obesity increases the intraoperative bleeding,the incidence of incision complications and the risk of adjacent vertebral degeneration in PLIF for DLSS.
作者
李建国
孙武
高春雨
高景华
杨克新
银河
LI Jian-guo;SUN Wu;GAO Chun-yu;GAO Jing-hua;YANG Ke-xin;YIN He(The Second Department of Spinal Surgery,Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2022年第7期593-597,共5页
Orthopedic Journal of China
关键词
肥胖
退行性腰椎管狭窄症
后路腰椎间融合术
obesity
degenerative lumbar spinal stenosis
posterior lumbar interbody fusion
