Fixed Postoperative Spinal Fusion Influence Factors Of Adjacent Segment Degeneration Occurs Clinical Research

Objective: in recent years, with the development of spine surgerytechnology and spinal internal fixation instrument matures, spinaldegeneration, trauma and tumor surgery is more and more widely used, withinternal fixation of spinal fusion rate is very high, but there is somecomplications after spinal fusion and internal fixation phenomenon, this kindof phenomenon, one of the most serious is the fusion of adjacent segmentaldegenerative diseases, such complications is more and more cause theattention of the researchers, for the incidence of degenerative diseases, theresearch report is not consistent, lead to inconsistent for many reasons, such asthe different method of surgery, the object of study, integration level and thenumber of the section and follow-up time, etc. After21years of follow-upreports that pathological changes in incidence was2.9%, after10years,25.6%of the cases of adjacent segment disease. And according to the report ofKatsuura,10years of follow-up found nearly half of all cases of adjacentsegment degeneration phenomenon, observed in reported Kulkarni,44patients,found that after10years of follow-up of adjacent segment degenerationaccelerated obviously, and three-quarters of the cases appeared degeneration.Based on this, this study select our hospital from2009to2011for spinalfusion fixation during postoperative patients were studied.Methods: our hospital during2009to2011were collected for spinalfusion regular postoperative patients were retrospectively study and follow-upstudy, this group of40cases. All patients were anesthetized before surgery,after the success of anesthesia, patients were prone position, chest andabdomen pad prone position under the mat.Specific operation, and theapplication of internal fixation materials, according to the different symptomsand the clinical manifestations of patients, divided into three groups. Group A: 11cases on both sides of the multi-segment cone and plate symmetricalwindows, fixed with pedicle screw system. Group B:16cases usingsemi-laminectomy decompression and fusion with internal fixation surgery; Cgroup:13patients with laminectomy fusion and internal fixation. All patientspostoperative routine use of antibiotics, anesthesia to start as early as possibleafter lower limb muscle contraction function of exercise, stay in bed for eightweeks, under the waist protection activities,3to5months after surgery toremove. Compared three groups of operation time, intraoperative blood loss,postoperative clinical symptoms improvement, bed time, complications;Quality of life assessment: application developed by the institute of medicineSF-36to evaluate quality of life scale, before the turn out of ICU patientscarries on the questionnaire survey; Followed up for3to5years for allpatients after treatment of the wound healing condition evaluation etc., usingX-ray, radiography review respectively, observing the healing of patients withspinal conditions. Follow-up of adjacent segmental degenerative diseasesoccurring: followed up for3to5years, degenerative diseases occurred inpatients with and without statistics, the data and surgical patients, age, gender,spinal lesions situation carries on the contrast analysis. All data usingSPSS16.0statistical software for processing, and all measurement data areused (plus or minus s) said, with T test between groups, using frequency countdata description, the chi-square test was used to P <0.05for the differencewas statistically significant.Results: all patients after surgery,,29cases (72.5%),7cases (17.5%),4cases (10%). Postoperative incision were primary healing, all patients werefollowed up. Three groups were successfully completed surgery, incisionshealed well. Three groups of patients in the intraoperative blood loss,operative time, bed time, complications has no statistical significance (P>0.05). Relief complications occurred mainly in group C, and the incidence ofother two groups have significant difference, P <0.05, the other threecomplications in3groups was no significant difference of relief complicationsprevention and control of the main is to note when surgery to remove damaged in the vertebral body between before and after removal of the disk, before itcan effectively avoid the injury of nerve root and dural sac afterdecompression.After statistics, the three groups in physiological function, body pain,emotional functions such as the quality of life score of no significantdifference (P>0.05).Followed up for3to5years, there are3cases of bone nonunion occurring,the incidence was6%. Prosthesis loosening occurred in2cases, bone dissolvein1case, the incidence was4%and2%of all patients were followed up in theprocess of no infection, no renovation; Follow-up of3years12cases occur,adjacent segmental degenerative diseases, the incidence of30%; Four yearsoccurred in18cases, the incidence of45%; Five years in25cases, incidenceof62.5%; Cases and incidence rate in3groups there were significantdifferences in the operation (P>0.05, R=0.05), and internal fixationmaterials and intraoperative complications have significant difference (P>0.05, R=0.05), with age, gender, spine lesions is no significant difference (P<0.05).Conclusion: postoperative spinal fusion and internal fixation of theoccurrence of degenerative diseases and various factors have a relationship,such as surgery, internal fixation materials, length of follow-up, thepostoperative complications, etc., so the treatment should be closely observed,reduce the occurrence of degenerative diseases.