改良腰椎后路椎间植骨单侧椎弓根螺钉固定在腰椎融合手术中的应用  

Modified posterior lumbar interbody fusion using unilateral pedicle screw fixation in lumbar spinal fusion

作　　者：朱云荣[1] 叶晓健[1] 蒋玉权[1] 余将明[1] 许国华[1] 

机构地区：[1]第二军医大学长征医院骨科,上海200003

出　　处：《第二军医大学学报》2010年第10期1095-1099,共5页Academic Journal of Second Military Medical University

基　　金：国家重点基础研究发展计划(2009CB930000);上海市自然科学基金(0852nm03100)~~

摘　　要：目的探讨采用改良腰椎后路椎间植骨单侧椎弓根螺钉固定术式在腰椎融合手术中的临床效果,并比较与传统腰椎后路椎间植骨椎弓根螺钉固定术式的术后疗效和并发症。方法随机选取2007年2月至2009年5月行腰椎后路融合手术96例进行回顾性研究,改良术式组(A组)40例,其中男14例,女26例,平均年龄(52.23±9.75)岁;传统术式组56例,其中男22例,女34例,平均年龄(56.02±10.25)岁。比较两组手术ODI评分、VAS评分、手术时间、出血量、住院时间、住院费用、植骨融合率、椎间隙高度等多项指标。结果两组术式术后短期ODI、VAS评分、椎间隙高度变化无明显差异。改良术式组较传统术式组手术时间短、出血量少、住院费用少(P<0.05)。术后12个月两组植骨融合率均为100%。结论改良腰椎后路椎间植骨单侧椎弓根螺钉固定是一种切实有效的腰椎融合术式,与传统术式相比具有创伤小、风险小和医疗费用少的优点,但远期疗效仍需进一步随访与研究。Objective To compare the clinical efficacies and complications between the posterior lumbar interbody fusion （PLIF）using bilateral pedicle screw fixation and modified PLIF using unilateral pedicle screw fixation.Methods A total of 96 patients who underwent lumbar spinal fusion operation during Feb.2007to May 2009were divided into 2groups.Group A included 40patients（14males and 26female,average age being[52.23±9.75]years）receiving unilateral modified PLIF; Group B included 56patients（22males and 34female,average age being[56.02±10.25]years）receiving bilateral PLIF. Oswestry disability index（ODI）,visual analog scale（VAS）,operating time,blood loss,length of hospital stay,hospitalization cost,fusion rates,complication rates,intervertebral height and medical expenses were all compared between the two groups. Results The short-term ODI,VAS indices showed no significant difference between the two groups.Blood loss,operating time,and hospitalization cost of group A were significantly less than those in group B（P〈0.05）.Fusion rate was 100%in both groups 12months after the operation.Conclusion Modified PLIF using unilateral pedicle screw fixation is effective for lumbar spinal fusion,and it has the less trauma,risk and hospitalization cost compared with PLIF using bilateral pedicle screw fixation;but its long-term efficacy still needs to be further observed.

关 键 词：改良腰椎后路椎体间融合术 单侧固定 腰椎体间融合术 治疗结果 

分 类 号：R681.533[医药卫生—骨科学]