腰椎间孔狭窄｜骨赘｜分型｜每日文献学习｜知识搬运工｜【Spine Atlas】20240505｜立夏

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相关推文

L5/S1要重视椎间孔狭窄

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退变性脊柱侧弯的腰骶碎片弯的凹侧，高度丢失。

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退变性腰椎滑脱常常伴随关节突关节增生，导致上关节突增生导致椎间孔狭窄加重。

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腰椎节段不稳在后伸位会加重椎间孔狭窄。

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椎间孔内骨赘分型：1混合骨赘，2上椎体的下终板骨赘，3上椎体椎弓根与椎板交界处骨赘，4下椎体的上终板骨赘。

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所以TLIF术后发生对侧症状的两个因素：cage偏手术侧而且偏高，这样对侧的高度丢失；植入cage时松解不够导致上位椎体旋转，下椎体的上关节突致椎间孔狭窄。

TLIF术后发生对侧神经症状

TLIF的术后并发症之一：对侧症状TLIF术后发生对侧神经症状

参考文献

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2. Lu W, Zhang J, Deng Y, et al. Analysis of risk factors for contralateral symptomatic foraminal stenosis after unilateral transforaminal lumbar interbody fusion. International Orthopaedics (SICOT) 2023;47:1815–26.

3. Fujita N, Yagi M, Yamada Y, et al. Changes in the lumbar intervertebral foramen between supine and standing posture in patients with adult spinal deformity: a study with upright computed tomography. Skeletal Radiol 2023;52:215–24.

4. Wang T, Wang L, Zang L, et al. Morphometric change in intervertebral foramen after percutaneous endoscopic lumbar foraminotomy: an in vivo radiographic study based on three-dimensional foramen reconstruction. International Orthopaedics (SICOT). Epub ahead of print December 24, 2022. DOI: 10.1007/s00264-022-05664-y.