目的探讨体质量指数(body mass index,BMI)对后路360°融合术治疗单节段腰椎退行性疾病疗效的影响。方法回顾分析2009年9月-2013年9月收治的符合选择标准的302例行后路360°融合术治疗的单节段腰椎退行性疾病患者临床资料。根...目的探讨体质量指数(body mass index,BMI)对后路360°融合术治疗单节段腰椎退行性疾病疗效的影响。方法回顾分析2009年9月-2013年9月收治的符合选择标准的302例行后路360°融合术治疗的单节段腰椎退行性疾病患者临床资料。根据术前BMI不同将患者分为3组,A组为正常体重组(BMI<24kg/m^2),105例;B组为超重组(24 kg/m^2≤BMI<28 kg/m^2),108例;C组为肥胖组(BMI≥28 kg/m^2),89例。3组患者性别、年龄、病程、病变类型、病变节段及术前日本骨科协会(JOA)评分与Oswestry功能障碍指数(ODI)比较差异均无统计学意义(P>0.05),具有可比性。记录患者手术时间、术中出血量、术后住院时间、术后并发症情况;术前及术后3、6、24个月采用腰椎JOA评分及ODI评价患者腰椎功能情况。结果 C组手术时间、术中出血量及术后住院时间均显著多于A、B组(P<0.05);A、B组间比较差异无统计学意义(P>0.05)。3组患者均获2年以上随访,随访时间24~45个月。各组术后各时间点JOA评分及ODI均较术前显著改善(P<0.05);术后各时间点3组间比较,差异均无统计学意义(P>0.05)。并发症发生情况:3组患者术后总体并发症发生率比较差异无统计学意义(χ~2=3.288,P=0.193)。其中C组切口相关并发症(切口感染和切口愈合不良)发生率显著高于A、B组(P<0.05),A、B组间差异无统计学意义(P>0.05);脑脊液漏、假关节形成及翻修等并发症发生率3组间比较差异均无统计学意义(P>0.05)。结论不同BMI的腰椎退行性疾病患者行后路360°融合术均能获得良好临床疗效,但BMI≥28 kg/m^2患者手术时间更长、术中出血更多、术后住院时间更长,且术后切口相关并发症发生率更高。展开更多
Congenital insensitivity to pain with anhidrosis （CIPA） is an autosomal recessive form of sensory neuropathymanifesting with the lack of perception of pain.^1 There have been few reports of Charcot spine in patients...Congenital insensitivity to pain with anhidrosis （CIPA） is an autosomal recessive form of sensory neuropathymanifesting with the lack of perception of pain.^1 There have been few reports of Charcot spine in patients with CIPA,^2 and surgery for such cases was accompanied by high revision proportion.^3＇4 The purpose of this report is to describe a patient with CIPA who developed a recurrent Charcot arthropathy in her lumbar spine and was treated by revision surgery, with the aim to discuss the strategy of surgical management for such cases.展开更多
文摘Congenital insensitivity to pain with anhidrosis （CIPA） is an autosomal recessive form of sensory neuropathymanifesting with the lack of perception of pain.^1 There have been few reports of Charcot spine in patients with CIPA,^2 and surgery for such cases was accompanied by high revision proportion.^3＇4 The purpose of this report is to describe a patient with CIPA who developed a recurrent Charcot arthropathy in her lumbar spine and was treated by revision surgery, with the aim to discuss the strategy of surgical management for such cases.
