小切口后路单纯Cage融合治疗慢性腰痛的疗效分析  

Effectiveness of minimally invasive stand-alone Cage with posterior lumbar interbody fusion for the treatment of the chronic low back pain

作　　者：贾瑞钢[1,2] 朱泽章[3] 

机构地区：[1]南京大学医学院研究生班 [2]明基医院,江苏南京210093 [3]南京大学附属鼓楼医院,江苏南京210008

出　　处：《生物骨科材料与临床研究》2013年第6期36-39,42,共5页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的 探讨小切口单纯椎间融合器(Cage)后路椎间融合治疗慢性腰痛的临床疗效.方法 回顾性分析我院2008年6月～2010年3月收治的10例伴腰椎终板信号改变(Modic改变)的慢性腰痛患者,采用小切口经后路单纯Cage椎间融合治疗,评价比较术前、术后初期的椎间隙高度,术前和末次随访时椎间隙高度、JOA、ODI值.结果 术后随访3～42个月,平均27.9个月,椎间隙高度术前、术后初期、末次随访时分别为(4.9±0.7)mm、(8.0±0.5)mm和(7.8±0.6)mm,术后初期明显增加(P＜0.01),末次随访时未见明显降低(P＞0.05),JOA值术前(17.0±2.7),末次随访时(22.4±3.7),ODI值术前(35.2±10.2),末次随访时(18.2±11.3),JOA值、ODI值改善均有统计学差异(P＜0.05).结论 小切口后路单纯Cage椎间融合手术对于慢性腰痛是一种可供选择的手术方法.Objective To evaluate the clinical and radiographic outcomes of minimally invasive stand-alone Cage for the treatment of the chronic low back pain(CLBP). Methods 10 CLBP patients with associated endplate Modic changes(MC)undergoing minimally invasive stand-alone Cage for PLIF at our clinic between June 2008 and March 2010 were identified and retrospectively reviewed. Radiographic(intervertebral height)were assessed pre- and postoperatively early and at the final follow-up, and clinical outcomes JOA values and ODI were assessed preoperatively and at the final followup. Results 10 cases were followed up 3 to 42 months(mean 27.9 months)postoperatively. Preoperative, postoperative early and at the final follow-up intervertebral height were(4.9±0.7)mm,(8.0±0.5)mm and(7.8±0.6)mm respectively. The differences of intervertebral height between preoperative and postoperative early were statistically significant( < 0.01), but differences between postoperative early and at the final follow-up weren't statistically significant( >0.05). The postoperative and at the final follow-up scores of ODI were(35.2±10.2)and(18.2±11.3), respectively; and operative and at the final follow-up JOA values were(17±2.7)and(22.4±3.7), respectively. The improvements of ODI and JOA scores were statistically significant( <0.05). Conclusion Minimally invasive stand-alone Cage for PLIF is an effective surgical alternative for treating CLBP with endplate MC.

关 键 词：椎间融合器 椎弓根螺钉系统 椎间隙高度 

分 类 号：R687.3[医药卫生—骨科学]