腰椎内固定术后顽固下腰痛原因分析.doc

腰椎内固定术后顽固下腰痛原因分析
袁建军1 阚世廉2 贾宇涛3 刘洋1 田融1
(1 天津医科大学研究生院天津市人民医院 300070,2天津医院300211,3天津市人民医
院300121)
作者简介:袁建军(1973-),男,天津人,副主任医师,博士在读,研究方向:脊柱外科,(电话)022-27557253,,**********,(电子信箱)@
摘要目的:分析腰椎柔韧性及关节突关节退变程度对腰椎内固定术后下腰痛缓解率的影响。方法:随访100例行腰4,5单节段内固定术患者,术前测量前屈、后伸位腰椎前凸角度的变化作为腰椎柔韧性指标,测量腰3,4关节突关节角,并进行退变程度分级,术前和术后1年对病人进行Oswestry评分,并计算改善率。分析腰椎柔韧性及关节突关节退变对术后下腰痛改善率的影响。结果:腰椎柔韧性与手术后症状改善率呈正相关。关节突关节退变严重组术后症状改善率差,关节突关节角不对称组术后改善率较差。结论:腰椎柔韧性、关节突关节角对称性和关节突关节退变程度是影响腰椎内固定术后下腰痛改善率的重要因素,可为判断临床预后提供参考。
关键词:腰椎内固定术柔韧性关节突关节改善率
The analysis of the causes of obstinate low back pian after lumbar internal fixation. YUAN Jian-jun,KAN Shi-lian,JIA Yu-tao(Graduate School of
Tianjin Medical of Spinal Surgery, People’s Hospital of Tianjin,Tianjin 300121,China)
Abstract objective: to investigate the effection of the lumbar flexibility, lumbar facet joint angle, facet joint degeneration on improvement rate of low back pain after lumbar internal fixation. method: 100 cases which undergone lumbar internal fixation of L4,L5 were followed up, facet joint angle of L3,4 was measured, degeneration of facet joint was graded, lumbar lordosis angle at extension and flexion position was measured aspectely, Oswestry score was obtained before and 1 year after operation. results:Lumbar flexibility is positively correlated with the improvement rate of low back pain,the patients with severe d