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首页> 外文期刊>Journal of Korean Neurosurgical Society >Surgical Outcomes of Post-Fusion Lumbar Flatback Deformity with Sagittal Imbalance
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Surgical Outcomes of Post-Fusion Lumbar Flatback Deformity with Sagittal Imbalance

机译：融合后腰椎后凸畸形并矢状不平衡的手术结果

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Objectives To review surgical results of post-fusion lumbar flatback treated with pedicle subtraction osteotomy (PSO) or Smith-Petersen osteotomies (SPOs). Methods Twenty-eight patients underwent osteotomies. Radiological outcomes by sagittal vertical axis (SVA), and pelvic tilt (PT), T1 pelvic angle (T1PA), and pelvic incidence (PI)-lumbar lordosis (LL) at preoperative, postoperative 1 month, and final were evaluated. Oswestry Disability Index (ODI), visual analog scale (VAS) score of back pain/leg pain, and Scoliosis Research Society-22 score (SRS-22r) were analyzed and compared. Patients were divided into 2 groups (SVA ≤5 cm : normal, SVA >5 cm : positive) at final and compared outcomes. Results Nineteen patients (68%) had PSO and the other 9 patients had SPOs with anterior lumbar interbody fusions (ALIFs) (Mean age : 65 years, follow-up : 31 months). The PT, PI-LL, SVA, T1PA were significantly improved at 1 month and at final ( p p p p >0.05). Common reoperations were early 4 proximal junctional failures (14%) and late four rod fractures. Conclusion Our results demonstrate that PSO and SPOs with ALIFs at the lower lumbar are significantly improves sagittal balance. For maintenance of normal SVA, PI-LL might be made negative value and T1PA might be less than 11° even though positive SVA group was also significantly improved clinical outcomes. Keywords: Post-fusion flatback deformity, Pedicle subtraction osteotomy, Smith-Petersen osteotomy, Anterior lumbar interbody fusion
机译：目的探讨椎弓根减影截骨术（PSO）或史密斯-彼得森截骨术（SPOs）治疗融合后腰椎后凸的手术效果。方法对28例患者行截骨术。评估术前，术后1个月和最终的矢状纵轴（SVA）和骨盆倾斜（PT），T1骨盆角度（T1PA）和骨盆发生率（PI）-腰椎前凸（LL）的放射学结果。分析并比较了Oswestry残疾指数（ODI），背痛/腿痛的视觉模拟量表（VAS）评分和脊柱侧弯研究学会22评分（SRS-22r）。在最终结果和比较结果中，将患者分为两组（SVA≤5cm：正常，SVA> 5 cm：阳性）。结果19例患者（68％）发生了PSO，另9例患者发生了SPO合并前腰椎椎间融合术（ALIF）（平均年龄：65岁，随访时间：31个月）。 PT，PI-LL，SVA，T1PA在1个月和最终时均显着改善（p p p p> 0.05）。常见的再手术是早期的4个近端连接失败（14％）和晚期的4个杆骨折。结论我们的研究结果表明，腰下部有ALIF的PSO和SPO可以显着改善矢状面平衡。为了维持正常的SVA，即使阳性的SVA组也可以显着改善临床结局，PI-LL可能会设为负值，T1PA可能会小于11°。关键词：融合后平背畸形，椎弓根减法截骨术，Smith-Petersen截骨术，前腰椎椎间融合

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