Analysis of Factors Contributing to Postoperative Spinal Instability after Lumbar Decompression for Spinal Stenosis
Korean Journal of Spine
;
: 149-154, 2013.
Article
Dans Anglais
| WPRIM
| ID: wpr-35268
ABSTRACT
OBJECTIVE:
Decompressive laminectomy is one of the most commonly used surgical methods for the treatment of spinal stenosis. We retrospectively examined the risk factors that induce spinal instability, including slippage (spondylolisthesis) and/or segmental angulation after decompressive laminectomy on the lumbar spine.METHODS:
From January 1, 2006 to June 30, 2010, 94 consecutive patients underwent first-time single level decompressive laminectomy without fusion and discectomy. Of these 94 patients, 42 with a follow-up period of at least 2 years were selected. We measured the segmental angulation and slippage in flexion and extension dynamic lumbar radiographs. We analyzed the following contributing factors to spinal instability age/sex, smoking history, disc space narrowing, body mass index (kg/m2), facet joint tropism, effect of the lordotic angle on lumbar spine, asymmetrical paraspinal muscle volume, and surgical method and level.RESULTS:
Female patients, normal lordotic angle, and asymmetrical paraspinal muscle volume were factors more significantly associated with spondylolisthesis (p-value=0.026, 0.015, <0.01). Statistical results indicated that patients with facet tropism were more likely to have segmental angulation (p-value=0.046). Facet tropism and asymmetry of paraspinal muscle volume were predisposing factors to spinal instability (p-value=0.012, <0.01).CONCLUSION:
Facet joint tropism and asymmetry of paraspinal muscle volume are the most important factors associated with spinal instability; therefore, careful follow-up after decompressive laminectomy in affected patients is necessary.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Fumée
/
Sténose du canal vertébral
/
Rachis
/
Spondylolisthésis
/
Fumer
/
Indice de masse corporelle
/
Causalité
/
Études rétrospectives
/
Facteurs de risque
/
Études de suivi
Type d'étude:
Etude d'étiologie
/
Étude observationnelle
/
Étude pronostique
/
Facteurs de risque
Limites du sujet:
Femelle
/
Humains
langue:
Anglais
Texte intégral:
Korean Journal of Spine
Année:
2013
Type:
Article
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