| 引用本文： |
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宋鑫,曹师锋,任东林,等.TLIF手术对近端椎体关节突关节的影响及相关因素分析[J].同济大学学报（医学版）,2017,38(5):69-73. [点击复制]
- SONG Xin,CAO Shi-feng,REN Dong-lin,et al.Incidence and risk factors of adjacent cranial facet joint violation following pedicle screw insertion using Weinstein technique in TLIF[J].同济大学学报（医学版）,2017,38(5):69-73. [点击复制]
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| 摘要: |
| 目的 观察采用Weinstein置钉方法的TLIF手术对近端椎体关节突关节的影响及相关因素分析。方法回顾性分析上海浦东新区人民医院骨科于2014年12月1日至2016年5月1日收治并行TLIF手术的退行性腰椎疾病患者，利用术后CT检查评估内固定物对近端关节突关节的影响。利用统计方法分析得出近端关节突关节损伤的危险因素。结果采用Weinstein置钉方法的TLIF手术内固定物对近端关节突关节的影响率为28.3%（28/99），其中有3例患者影像学检查提示关节突关节2度损伤。Logistic回归分析提示： 年龄、术前存在椎体滑脱及严重的关节突关节退变是TLIF手术中内固定物损伤近端关节突关节的高危因素（P<0.05）。结论采用Weinstein置钉方法的TLIF手术内固定物对近端椎体关节突关节具有一定影响，多见于高龄，严重的小关节退变及腰椎滑脱患者。 |
| 关键词: 椎弓根钉 螺钉植入 关节突关节破坏 近端关节突关节 |
| DOI：10.16118/j.1008-0392.2017.05.014 |
| 投稿时间：2017-03-09 |
| 基金项目:上海市浦东新区卫生系统学科带头人培养计划（PWRD-01） |
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| Incidence and risk factors of adjacent cranial facet joint violation following pedicle screw insertion using Weinstein technique in TLIF |
| SONG Xin,CAO Shi-feng,REN Dong-lin,SHEN Yan-guo,SUN Wan-ju,WU De-sheng |
| (Dept. of Orthopedics, Shanghai Pudong New District Peoples Hospital, Shanghai 201299, China;Dept. of Spine Surgery, East Hospital, Tongji University, Shanghai 200120, China) |
| Abstract: |
| Objective To determine the incidence and risk factors of cranial facet joint violation (FJV) following screw placement via Weinstein technique in transforaminal lumbar interbody fusion (TLIF). MethodsWe reviewed 99 consecutive patients who underwent lumbar pedicle screw instrumentation using Weinstein technique in TLIF from December 2014 to May 2016. Postoperative CT scans were obtained to determine the degree and incidence of FJV. Clinical and imaging data were analyzed to analyze the risk factors of FJV. ResultsThe incidence of FJV by the proximal screws was 28.3%（28/99）, with 3 cases of intra-articular FJV. Multiple Logistic regression analysis revealed that older age, vertebral slip, and severe adjacent facet joint degeneration were independent risk factors of FJV. ConclusionLumbar pedicle screw placement via Weinstein technique in TLIF would also cause FJV, especially in patients with older age, vertebral slip and severe facet degeneration. |
| Key words: pedicle screw screw insertion facet joint violation cranial facet joint |
