改良Jaslow技术与PLIF对峡部裂型腰椎滑脱症腰椎-骨盆矢状面参数的影响对比
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1.徐州医科大学附属医院;2.上海交通大学医学院附属第九人民医院

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国家自然科学基金青年科学基金项目,国家自然科学基金项目(面上项目,重点项目,重大项目)


Comparison of modified Jaslow technique and PLIF for the spine-pelvic sagittal parameters in isthmic spondylolisthesis
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Affiliation:

1.The Affiliated Hospital of Xuzhou Medical University;2.Ninth People’s Hospital, Shanghai Jiaotong University

Fund Project:

National Natural Science Foundation of China

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    摘要:

    [目的]比较改良Jaslow技术与PLIF对峡部裂型腰椎滑脱症腰椎-骨盆矢状面参数的影响。[方法]2014年12月~2017年3月共纳入L5/S1单节段中、重度峡部裂型腰椎滑脱症患者87例,49例采用改良Jaslow技术治疗;38例采用PLIF治疗。采用K-Means聚类分析,依据PT、SS相对比值分为平衡型和失平衡型。记录各项指标评价两组手术效果。[结果]①Jaslow组的手术时间、术中出血量、术后引流量均低于PLIF组,差异有统计学意义(p<0.05);术后两术式组JOA、VAS、ODI均显著改善(p<0.05)。②平衡组中,两术式△SP、△SA、△LL、△PT之间无明显差异(p>0.05);Jaslow组中CS为1.15±0.53mm,低于PLIF组的1.54±0.59mm,但无明显差异(p>0.05);Jaslow组中SR为6.3%,显著低于PLIF组的29.0%(p<0.05)。③失平衡组中,Jaslow组的△SP、△SA、△LL、△PT均显著大于PLIF组(p<0.05);Jaslow组中CS和SR分别为1.15±0.53mm、6.3%,显著低于PLIF组的1.54±0.59mm、29.0%(p<0.05)。[结论]对于峡部裂型腰椎滑脱症,改良Jaslow技术和PLIF同样可获得满意的临床疗效,较好地恢复腰椎前凸角及腰椎-骨盆矢状面平衡。对于腰椎-骨盆矢状面失平衡患者,改良Jaslow技术能更有效地减小滑脱度、滑脱角及骨盆倾斜角,恢复腰椎前凸角及矢状位平衡。

    Abstract:

    [Objective]To compare the influence between modified Jaslow technique combined with single Z-Cage and PLIF on spine-pelvic sagittal parameters in isthmic spondylolisthesis patients.[Methods]From December 2014 to March 2017,87 patients with L5/S1 single-segmental isthmic spondylolisthesis were included,of which 49 patients were treated with modified Jaslow technique;38 patients were treated with PLIF.K-Means cluster analysis was used to classify patients into balanced and unbalanced types based on the relative ratios of PT and SS.Some indicators were recorded to evaluate the treatment of surgery in both groups.[Results]①The operation time,intraoperative blood loss and postoperative drainage volume of the Jaslow group were significantly lower than those of the PLIF group(p<0.05).The JOA,VAS and ODI of the two surgical groups were significantly improved(p<0.05)②In balanced pelvic group,there was no statistical difference between the two groups of △SP,△SA,△LL,△PT.The CS in Jaslow group was 1.15±0.53mm,which was lower than that in PLIF group(1.54±0.59mm)(p>0.05),but there was no statistical difference.The SR in Jaslow group was 6.3%,which was significantly lower than that in PLIF group (29.0%,p<0.05).③In unbalanced pelvic group,△SP,△SA,△LL,△PT in Jaslow group were significantly greater than those in PLIF group(p<0.05);CS and SR in Jaslow group were 1.15±0.53mm and 6.3%,significantly lower than that in PLIF group(1.54±0.59mm,29.0%,p<0.05).[Conclusion]For the isthmic spondylolisthesis,modified Jaslow technique and PLIF can also obtain satisfactory clinical results,restore the lumbar lordosis,and the lumbar-pelvic sagittal balance.For severe lumbar spondylolisthesis patients with unbalanced pelvic,the modified Jaslow technique can also reduce slip percentage,slip angle and pelvic tilt angle,and restore lumbar lordosis and sagittal balance more effectively.

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  • 收稿日期:2019-03-25
  • 最后修改日期:2019-05-13
  • 录用日期:2019-05-21
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