腰椎融合后邻近节段退变的研究进展

Research progress in adjacent segment degeneration secondary to lumbar fusion

摘要:

邻近节段退变 （adjacent segment degeneration, ASD） 是指脊柱融合术后邻近节段发生的退变性疾病，其危险因素众多，可能涉及高龄、超重、邻近节段退变程度、骨质疏松、脊柱-骨盆的矢状面失衡、手术方式的选择、术中减压融合节段数量以及解剖结构的破坏程度等因素。目前腰椎融合术后 ASD 的发病率及致残率较高，如何有效预防及治疗腰椎融合术后 ASD 是目前脊柱退变性疾病研究的热点与难点，因此笔者综述近 10 余年关于邻近节段退变的文献报道，旨在进一步为临床提供理论参考，降低腰椎融合术后邻近节段退变的发病率，提高腰椎融合术患者的远期临床疗效。

Abstract:

Adjacent segment degeneration (ASD) refers degenerative disorder of the adjacent disc following spinal fusion, with many risk factors, such as advanced age, overweight, previous degeneration of the segment, osteoporosis, sagittal spine-pelvis imbalance, choice of surgical techniques, number of segments of intraoperative decompression and fusion, destruction extent of anatomical structure involved. The incidence and morbidity of ASDs after lumbar fusion remain relatively high at present, and how to effectively prevent and treat ASDs af- ter lumbar fusion is a hot and difficult topic in the research of spinal degenerative diseases. Therefore, we reviewed the literature reports on adjacent segment degeneration over the past 10 years, aiming to provide further theoretical reference for clinical practice and reduce the inci- dence of adjacent segment degeneration after lumbar fusion to improve the long-term clinical effect of lumbar fusion.