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首页> 外文期刊>Asian spine journal. >Posterior Dural Shifts Following Spinous Process-Splitting Multi-Level Intervertebral Lumbar Laminectomies
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Posterior Dural Shifts Following Spinous Process-Splitting Multi-Level Intervertebral Lumbar Laminectomies

机译:棘突分裂多级腰椎间盘切除术后硬膜后移位

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Study Design Retrospective cohort study. Purpose The aim of our study is to evaluate the extent of posterior spinal dural shift following spinous process splitting multi-level intervertebral lumbar laminectomies, and determine the relationship between posterior spinal dural shift and preoperative parameters. Overview of Literature There are no existing studies on the posterior spinal dural shift after spinous process-splitting multi-leveled lumbar laminectomies. Methods We examined 37 patients who underwent spinous process-splitting laminectomies in at least two intervertebral levels, including at the L5/S level. We defined the distance between the vertebral bodies and the anterior edge of the dural sac in the magnetic resonance images at the L5 vertebral level as the anterior dural space (ADS) and detected the difference (d-ADS) between preoperative ADS (pre-ADS) and postoperative ADS (post-ADS). We assessed the relationship between ADS or d-ADS, and preoperative parameters, including age, sex, lumbar lordosis, focal lordosis (FL), and number of decompression levels. Results Post-ADS was significantly greater than pre-ADS ( p 0.001). Pre-ADS was significantly correlated with FL ( p =0.44, p 0.01) and also with post-ADS ( p =0.43, p 0.01). d-ADS was negatively correlated with pre-ADS ( p =?0.37, p 0.05). A single regression analysis revealed that the relationship between d-ADS and pre-ADS was described as d-ADS=3.67?0.46×pre-ADS. In one of three patients whose d-ADS was above the range of two standard errors, reoperation was performed because of impingement of the nerve root caused by the excessive posterior dural shift. Conclusions Posterior dural shifts occur after spinous process-splitting multi-level lumbar laminectomies, including at the L5/S level. FL and pre-ADS are good predictive factors for posterior dural shift. Excessive posterior dural shift may lead to stretching and impingement of nerve roots and thus require attention.
机译:研究设计回顾性队列研究。目的本研究的目的是评估在棘突分裂多级椎间盘腰椎椎管切开术后脊柱后硬脊膜移位的程度,并确定脊柱后硬脊膜移位与术前参数之间的关系。文献综述目前尚无关于棘突分叉多级腰椎开颅手术后后硬脊膜移位的研究。方法我们检查了37例至少在两个椎间盘水平(包括L5 / S水平)进行过棘突劈开术的患者。我们在L5椎骨水平的磁共振图像中将椎体与硬膜囊前边缘之间的距离定义为前硬脑膜间隙(ADS),并检测术前ADS(pre-ADS)之间的差异(d-ADS) )和术后ADS(post-ADS)。我们评估了ADS或d-ADS与术前参数之间的关系,包括年龄,性别,腰椎前凸,局灶性前凸(FL)和减压水平数。结果ADS后明显高于ADS前(p <0.001)。 ADS前与FL显着相关(p = 0.44,p <0.01),也与ADS后(p = 0.43,p <0.01)相关。 d-ADS与pre-ADS呈负相关(p =?0.37,p <0.05)。一次回归分析表明,d-ADS与pre-ADS之间的关系被描述为d-ADS =3.67≤0.46×pre-ADS。在d-ADS超过两个标准误差范围的三名患者中,一名患者由于过度的后硬脑膜移位引起神经根受累而进行了再次手术。结论棘突分裂多级腰椎开颅手术后发生硬脑膜后移位,包括L5 / S级。 FL和ADS前是硬脑膜后移位的良好预测因素。后部硬脑膜过度移位可能导致神经根伸展和撞击,因此需要引起注意。

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