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| LIU Xiao,YANG Xiaosong,YU Miao.Clinical analysis for change of postoperative adjacent segmental rotation angle, intervertebral motion and intervertebral height[J].Chinese Journal of Spine and Spinal Cord,2019,(2):109-115. |
| Clinical analysis for change of postoperative adjacent segmental rotation angle, intervertebral motion and intervertebral height |
| Received:September 16, 2018 Revised:November 14, 2018 |
| English Keywords:Lumbar spine Spinal fusion Adjacent segments degeneration Clinical effect |
| Fund:北京大学第三医院临床学科重点项目基金（编号：BYSY2016019）；AO Spine China Research Grant[编号：AOSCN（R）2017-19] |
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| English Abstract: |
| 【Abstract】 Objectives: To evaluate the effect of lumbar fusion for adjacent segments degeneration(ASD) by spinal moire system(DIERS Formetric 4D, Diers International GmbH, Schlangenbad, Germany) and radiological examination. Methods: The data of 73 patients who received single segmental lumbar fusion were collected in this study from January 2016 to June 2016. There were 40 male and 33 female cases with an average of 47.2±10.3(40-60) years old. The DIERS spinal moire system was applied to collect and calculate the relative rotation angle between fusion level and adjacent vertebrae during walk pre-operation at postoperative 6, 12 and 24 months respectively. X-ray examination was applied to evaluate the range of motion(ROM) and disc height(DH) of adjacent levels before and after operation. At the final follow-up, the low back and leg pain and lumbar function were evaluated by visual analogue scale(VAS) and Oswestry disability index(ODI). According to degeneration, the patients were divided into ASD group and non-ASD group and were compared and analyzed. Results: The relative rotation angle of upper and lower adjacent vertebrae was 5.2°±2.1° and 3.1°±2.1° before operation, while both angles increased obviously at each follow-up point(P＜0.05). Finally, the upper and lower angle was 8.8°±4.9° and 5.9°±3.2° respectively(P＜0.05). The most obvious changes were observed in the patients with L2-3 fusion. At the final follow-up, 11 patients suffered from ASD whose upper relative rotation angle was larger(P＜0.05). The relative rotation angle of the upper adjacent vertebrae in the degenerative group was 10.6±3.0, and that in the non-degenerative group was 8.2±2.8. The degenerative group was larger than that in the non-degenerative group(P<0.05). The VAS scores of low back pain in degenerative and non-degenerative groups were 1.4±0.7 and 1.2±0.8, leg pain were 1.2±1.0 and 1.3±0.7 and ODI were (10.3±8.2)% and (9.5±6.3)% respectively. The DH, ROM and clinical outcome showed no significant differencebetween the 2 groups(P＞0.05). Conclusions: The relative rotation angle, especially upper one, increases obviously after operation which maybe a more sensitive index to predict ASD compared to ROM and DH. |
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