个性化腰椎经椎弓根切除术的长期临床疗效和邻近近节段退行性疾病发病率分析

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详细

前瞻性评估个性化腰椎经椎间孔融合术的远期临床结果和邻近近节段退行性疾病的发生率。根据已建立的登记册，2015-2019年接受原发性开放式经椎间孔腰椎椎体切除术的209例患者被纳入观察性前瞻性多中心研究。手术按照公认的适应症在 LIV-SI 椎体运动节段水平进行。相邻椎体运动节段有不同程度的相邻节段原有退变。通过应用原始方法（俄罗斯联邦专利 2762496，2021 年 12 月 21 日，第 36 号公告）评估了近端椎体运动节段发生邻近节段退行性病变的风险。根据个性化开放式经胸腰椎棘突切除术的算法，确定了邻近椎体运动节段的手术策略。术前研究了器械参数，而在远处研究邻近节段退行性疾病的发展频率。术后随访 65 (60;74) 个月。在对邻近节段发生退行性疾病的风险进行综合评估后，对 75 例病例实施了单节段开放性经椎间孔腰椎切除术。69例行开放经椎间孔腰椎融合术，伴相邻椎体运动节段椎间稳定，在 65 例病例中，邻近的椎体运动节段参与了刚性稳定。邻近节段退行性疾病的发生率为4.9%（n = 10）。因此，对邻近节段退行性疾病的风险进行全面评估，并采用个性化算法进行经胸腰椎开放手术，可显著改善长期临床效果，并在最短五年随访期内降低邻近节段退行性疾病的发病率。

作者简介

Alexey V. Spiridonov

Irkutsk State Medical University; Regional Clinical Hospital of Krasnoyarsk

Email: av_spiridonov@bk.ru
ORCID iD: 0000-0003-3244-4688
SPIN 代码: 4676-9573

graduate student

俄罗斯联邦, Irkutsk; Krasnoyarsk

Yuri Ya. Pestryakov

Irkutsk State Medical University; Regional Clinical Hospital of Krasnoyarsk

Email: pestryakov-nho@mail.ru
ORCID iD: 0000-0001-7076-571X
SPIN 代码: 8933-1410

MD, Cand. Sci. (Med.)

俄罗斯联邦, Irkutsk; Krasnoyarsk

Andrei A. Kalinin

Irkutsk State Medical University; Railway Clinical Hospital

Email: andrei_doc_v@mail.ru
ORCID iD: 0000-0002-6059-4344
SPIN 代码: 9707-8291

MD, Cand. Sci. (Med.), associate professor, Department of Neurosurgery

俄罗斯联邦, Irkutsk; Irkutsk

Vadim A. Byvaltsev

Irkutsk State Medical University; Railway Clinical Hospital; Irkutsk State Medical Academy of Postgraduate Education – branch of the Federal State Budgetary Educational Institution DPO RMANPO of the Ministry of Health of the Russian Federation

编辑信件的主要联系方式.
Email: byval75vadim@yandex.ru
ORCID iD: 0000-0003-4349-7101
SPIN 代码: 5996-6477

MD, Dr. Sci. (Med.), professor, Department of Neurosurgery

俄罗斯联邦, Irkutsk; Irkutsk; Irkutsk

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