钽金属椎间融合器在腰椎间盘突出症减压术后复发融合术中的应用  

Application of lumbar interbody fusion with the tantalum cage in the recurrent lumbar disc herniation after decompression

作　　者：贺瑞[1] 张文志[1] 尚希福[1] 许翔[1] 胡业丰[1] 罗正亮[1] 葛畅[1] 段丽群[1] 李旭[1] 程鹏[1] 

机构地区：[1]安徽医科大学附属省立医院骨二科,安徽合肥230001

出　　处：《颈腰痛杂志》2013年第5期387-390,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨钽金属椎间融合器在腰椎间盘突出症术后椎间盘复发二次手术椎间融合的效果,分析其可行性。方法 2009-09-2010-04月22例,男8例,女14例,年龄34-67岁,平均62.3岁,所有患者均采用经关节突入路椎体间融合(TLIF),术中钉棒系统国产14例,进口8例。所有患者均使用切除椎板骨质和关节突切除骨质作为植骨材料,未再另行取骨。术后每月随访一次,全部行X线检查,部分患者行CT检查,了解内固定位置和融合器位置以及椎间植骨融合情况,评价其融合效果。结果所有患者均顺利完成手术,不适症状均明显改善,所有患者无钉棒断裂,无椎间融合器下沉,术后X线随访椎间植骨融合平均4.6月。术中1例椎间融合器断裂术后无不适,4月后X线显示位置正常,椎间植骨融合。结论钽金属椎间融合系统治疗腰椎间盘突出术后复发,特别是全椎板切除术后的患者具有植骨量少,融合快,并发症少等优点。Objective To assess the treatment effect and feasibility of lumbar interbody fusion with titanium cage for recurrent lumbar disc herniation. Methods Twenty-two patients （8 males, 14 females;average 62.3 years old,ranged from 34 to 67） with recurrent lumbar disc herniation af-ter decompression were recruited from September 2009 to April 2010. All patients were treated with transforaminal posterior lumbar interbody fusion （TLIF）,and domestic nail-stick systems were applied in 14 patients,imported in 8 patients. Intervertebral bone grafting was the resection part of the vertebral lamina and articular process. All patients were observed every month by X-ray and partially by CT. The outcomes were evaluated by intervertebral bony fusion and location of internal fixation and cage. Results Each operation was successfully completed,and the postoperative symp-toms were significantly improved. There was no cage subsidence and broken nail-stick in the pa-tients,and all patients got bony fusion of the fixation segments within 4.6 months. One patient with cage broken showed no postoperative discomfort,and X-ray showed bony fusion and no cage dis-placement 4 months after operation. Conclusion The lumbar interbody fusion with the tantalum cage in the treatment of recurrent lumbar disc herniation after decompression especially for total laminectomy has the advantage of less bone grafts,quicker bony fusion,and less complications.

关 键 词：腰椎 术后 复发 融合 植骨 钽金属 

分 类 号：R681.53[医药卫生—骨科学]