目的:本研究旨在探讨腰腹膜(LP)分流失败的原因并确定腰椎导管骨折的危险因素。
方法:我们回顾性调查了在2012年1月至2023年3月期间在我们医院接受LP分流的149例患者。分流重建22例(14.8%)。其中,失败的原因是5例(22.7%)的腰椎导管骨折。患者背景,低压分流故障的原因,手术技术因素,提取解剖学特征进行对比分析,分析腰椎导管骨折的危险因素。
结果:与未再手术组(n=127)相比,腰椎导管骨折患者趋于年轻(63±20vs.初次LP分流后72±11年)和良好的神经系统状况(改良的Rankin量表评分≤2);但是差异不显着。腰椎导管骨折组腰椎前凸明显增高(52.7°±14.8°vs.37.1°±12.3°;P=0.0067)。
结论:腰椎前凸过度是LP分流患者腰椎导管骨折的危险因素。年龄较小和术后日常生活活动水平较高也可能与腰椎导管骨折有关。
OBJECTIVE: This study aimed to investigate the causes of lumboperitoneal (LP) shunt failure and determine risk factors for lumbar catheter fracture.
METHODS: We retrospectively investigated 149 patients who underwent LP shunting in our hospital between January 2012 and March 2023. Shunt reconstruction occurred in 22 patients (14.8%). Among these, cause of failure was lumbar catheter fracture in 5 (22.7%). Patient backgrounds, cause of LP shunt failure, surgical technique factors, and anatomical characteristics were extracted for comparative analysis and risk factors of lumbar catheter fracture were analyzed.
RESULTS: Compared with the no reoperation group (n = 127), patients in the lumbar catheter fracture tended to be younger (63 ± 20 vs. 72 ± 11 years) and favorable neurologic status (modified Rankin scale score ≤2) after initial LP shunt; however, the differences were not significant. Lumbar lordosis was significantly higher in the lumbar catheter fracture group (52.7°± 14.8° vs. 37.1°± 12.3°; P = 0.0067).
CONCLUSIONS: Excessive lumbar lordosis is a risk factor for lumbar catheter fracture in patients undergoing LP shunting. Younger age and higher level of postoperative activities of daily living might also be associated with lumbar catheter fracture.