骨质疏松对颈前路减压椎间融合固定术后相邻节段异位骨化的影响
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摘要
目的分析骨质疏松对颈前路减压椎间融合(Anterior cervical decompression fusion,ACDF)术后相邻节段异位骨化的影响。方法以本院2015-01-2017-03行ACDF治疗的120例颈椎病患者为研究对象,测定记录患者术前、术后1年骨密度值及术后1年相邻节段异位骨化情况,分析术前骨质疏松分级、骨质疏松变化与相邻节段异位骨化的相关性。结果术后1年无异位骨化(0级)65例,骨化1级35例,骨化2级20例;Spearman相关分析发现,术前骨质疏松分级与相邻节段异位骨化程度正相关(P<0.05);术后骨质疏松变化越好,相邻节段异位骨化程度越低,即两者负相关(P<0.05);术前、术后1年患者骨密度均随异位骨化分级增大而显著降低(P<0.05)。结论术前骨质疏松可能是导致ACDF患者术后相邻节段异位骨化发生的危险因素,抗骨质疏松干预可能降低术后相邻节段异位骨化的发生率。
Objective To analyze the effect of osteoporosis on adjacent segmental heterotopic ossification after anterior cervical decompression and fusion(ACDF). Methods From January 2015 to March 2017, 120 patients with cervical spondylosis treated by ACDF in our hospital were studied. The bone mineral density before operation and at 1 year after operation and adjacent segmental heterotopic ossification in 1 year after operation were determined and recorded. Spearman correlation analysis was performed to analyze the correlation of preoperative grade of osteoporosis, osteoporosis changes(comparison of bone mineral density at 1 year after operation and before operation) with adjacent segmental heterotopic ossification. Results One year after surgery, there were 65 cases of undifferentiated ossification(grade 0), 35 cases of ossification(grade 1) and 20 cases of ossification(grade 2). Spearman correlation analysis found that preoperative osteoporosis grade was positively correlated with the degree of heterotopic ossification in adjacent sections(P<0.05). The better the postoperative osteoporosis change, the lower the degree of heterotopic ossification of adjacent segments,that was, the negative correlation between them(P <0.05). The bone mineral density of the patients before and 1 year after operation decreased significantly with the increase of heterotopic solidification grade(P<0.05). Conclusion Preoperative osteoporosis may be a risk factor for postoperative heterotopic ossification in patients undergoing ACDF. Anti-osteoporosis intervention and osteoporosis relief may decrease the incidence rate of postoperative adjacent segmental heterotopic ossification.
Objective To analyze the effect of osteoporosis on adjacent segmental heterotopic ossification after anterior cervical decompression and fusion(ACDF). Methods From January 2015 to March 2017, 120 patients with cervical spondylosis treated by ACDF in our hospital were studied. The bone mineral density before operation and at 1 year after operation and adjacent segmental heterotopic ossification in 1 year after operation were determined and recorded. Spearman correlation analysis was performed to analyze the correlation of preoperative grade of osteoporosis, osteoporosis changes(comparison of bone mineral density at 1 year after operation and before operation) with adjacent segmental heterotopic ossification. Results One year after surgery, there were 65 cases of undifferentiated ossification(grade 0), 35 cases of ossification(grade 1) and 20 cases of ossification(grade 2). Spearman correlation analysis found that preoperative osteoporosis grade was positively correlated with the degree of heterotopic ossification in adjacent sections(P<0.05). The better the postoperative osteoporosis change, the lower the degree of heterotopic ossification of adjacent segments,that was, the negative correlation between them(P <0.05). The bone mineral density of the patients before and 1 year after operation decreased significantly with the increase of heterotopic solidification grade(P<0.05). Conclusion Preoperative osteoporosis may be a risk factor for postoperative heterotopic ossification in patients undergoing ACDF. Anti-osteoporosis intervention and osteoporosis relief may decrease the incidence rate of postoperative adjacent segmental heterotopic ossification.
引文
[1]徐远金,杨俊峰.前路减压植骨融合联合钢板置入内固定治疗脊髓型颈椎病的效果分析[J].颈腰痛杂志,2017,38(6):598-599.
[2]陈文恒,郭团茂,刘强,等.双节段ACDF和单节段ACCF手术治疗脊髓型颈椎病疗效比较[J].实用骨科杂志,2017,23(2):100-104.
[3]林勇,柴生颋.抗骨质疏松治疗对骨质疏松症患者合并腰椎间盘突出症的防治作用[J].颈腰痛杂志,2017,38(2):124-127.
[4] Miyakoshi N,Itoi E,Murai H,et al. Inverse relation betweenosteo-porosis and spondylosis in postmenopausal women asevaluated by bone mineral density and semiquantitative scoring of spinal degeneration[J]. Spine,2003,28(5):492-495.
[5]黄东海,尤瑞金,肖奕增,等.骨质疏松与ACDF术后相邻节段骨化的相关性分析[J].实用骨科杂志,2017,23(4):301-305.
[2]陈文恒,郭团茂,刘强,等.双节段ACDF和单节段ACCF手术治疗脊髓型颈椎病疗效比较[J].实用骨科杂志,2017,23(2):100-104.
[3]林勇,柴生颋.抗骨质疏松治疗对骨质疏松症患者合并腰椎间盘突出症的防治作用[J].颈腰痛杂志,2017,38(2):124-127.
[4] Miyakoshi N,Itoi E,Murai H,et al. Inverse relation betweenosteo-porosis and spondylosis in postmenopausal women asevaluated by bone mineral density and semiquantitative scoring of spinal degeneration[J]. Spine,2003,28(5):492-495.
[5]黄东海,尤瑞金,肖奕增,等.骨质疏松与ACDF术后相邻节段骨化的相关性分析[J].实用骨科杂志,2017,23(4):301-305.