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目的分析L5椎体肿瘤术中置入钛网高度及其相关因素,为L_5椎体肿瘤患者术前预测钛网理想高度提供参考。方法回顾性分析37例L_5椎体肿瘤行后路腰椎肿瘤切除重建内固定术患者的临床资料,包括性别、身高、体质量、脊柱相关节段高度、术中置入钛网的高度。采用Student’s t检验法分别比较压缩性骨折和非压缩形骨折患者置入钛网中轴高度(Ht)与L_4下缘至S1上缘高度(H)的差异,以及压缩性骨折和非压缩性骨折患者间Ht的差异;并利用单因素线性相关分析、多元线性回归分析法进一步筛选影响Ht的因素,并推导选择合适Ht的公式。结果术前存在L5椎体压缩性骨折的患者Ht普遍长于H,无压缩性骨折患者Ht则短于H。身高和L_4/L_5椎间盘高度(H_(L4/L5))是Ht的回归参数,回归方程为Ht(mm)=0.467×身高(cm)+0.628×H_(L4/L5)(mm)-36.215。结论 L_5椎体肿瘤行后路腰椎肿瘤切除重建内固定术中置入钛网的理想高度与患者身高和L_4/L_5椎间盘高度相关。术前存在压缩性骨折的患者术中置入的钛网应适当长于术前L_4下缘至S1上缘距离,而无压缩性骨折患者反之。
Objective To analyze the height of titanium mesh in L5 vertebral tumor and its related factors, and to provide a reference for the preoperative prediction of the ideal titanium mesh in patients with L5 vertebral body tumors. Methods The clinical data of 37 patients with L5 vertebral body tumors underwent resection and reconstruction of posterior lumbar tumors were retrospectively analyzed. The data included sex, height, body mass, the height of the spine related segments, and the height of the titanium mesh in operation. Student’s t-test was used to compare the differences in axial height (Ht) between titanium mesh and the lower edge of L_4 to the upper edge height (H) of S1 in patients with compression and non-compression fractures, as well as between compressive and non-compressive fractures Ht differences between patients; and using single factor linear correlation analysis, multiple linear regression analysis to further screen factors that affect Ht, and derive the formula to select the appropriate Ht. Results The preoperative L5 vertebral compression fractures in patients with Ht generally longer than H, Ht without compression fractures in patients shorter than H. Height and height of L_4 / L_5 intervertebral disc (H_ (L4 / L5)) are regression parameters of Ht. The regression equation is Ht (mm) = 0.467 × height (cm) +0.628 × H_ (L4 / L5) (mm) -36.215. Conclusions The ideal height of titanium mesh in the L5 vertebral body lumbar tumor resection and reconstruction and internal fixation is related to the height and L4 / L5 intervertebral disc height. Preoperative compression fractures in patients with titanium mesh surgery should be properly longer than the preoperative edge of the lower edge of L_4 to S1 distance, while non-compression fractures in turn.