侧路与后路单椎间融合器联合单侧钉棒置入治疗腰椎退行性疾病  

Lateral and posterior single cage combined with unilateral pedicle screw fixation for lumbar degenerative disease

作　　者：严冬雪[1] 黄永吉[1] 马广斌[1] 罗军[2] 胡军祖[1] 肖荣驰[1] 

机构地区：[1]桂林医学院附属医院脊柱骨病外科,广西壮族自治区桂林市541001 [2]南方医科大学附属花都区人民医院骨科,广东省广州市510800

出　　处：《中国组织工程研究》2014年第4期541-546,共6页Chinese Journal of Tissue Engineering Research

基　　金：广西壮族自治区卫生厅科研课题(Z2009052)~~

摘　　要：背景:腰椎不稳、腰椎间盘突出症、椎间盘源性腰腿疼等腰椎退行性疾病常需实施椎间融合,但采用哪一种植入物进行植入好?还存在争议。目的:比较L4、5侧路单椎间融合器椎间融合与传统开放后路单椎间融合器联合单侧钉棒内固定的椎间融合治疗腰椎退行性疾病的疗效。方法:回顾性分析符合标准的L4、5单节段退变患者的临床资料,其中30例行侧路单椎间融合器内固定治疗(试验组),45例行后路单椎间融合器联合单侧钉棒内固定的椎间融合(对照组),比较两组疗效。结果与结论:两组患者均获随访,随访时间10-37个月,平均13个月。两组切口均Ⅰ期愈合,试验组1例出现内固定后椎间融合器移位但无相应症状发生。两组患者治疗后有效率、住院天数、引流量比较差异无显著性意义(P>0.05),植入治疗时间及植入治疗中出血量试验组优于对照组(P<0.05),两组患者的治疗后ODI及JOA评分较治疗前有明显变化,差异有显著性意义(P<0.05),但两组之间比较差异无显著性意义(P>0.05)。两种方式治疗部分腰椎退变性疾病效果相当,但侧路单椎间融合器内固定创伤小、治疗后恢复快。BACKGROUND： Most of lumbar degenerative diseases, such as lumbar instability, lumbar disc herniation and discogenic lumbago, need lumbar spinal fusion for the spine stability, but the choice of internal fixation approaches is controversial. OBJECTIVE： To compare the effectiveness between lateral lumbar interbody fusion with single cage and single cage combined with unilateral pedicle screw fixation for the 4th and 5th single-level lumbar degenerative disease. METHODS： The clinical data of patients with single-level lumbar degenerative diseases （L4 and L5） undergoing lateral lumbar interbody fusion with single cage in 30 cases （experimental group） and single cage combined with unilateral pedicle screw fixation in 45 cases （control group） were analyzed retrospectively, and the curative effects were compared between the two groups. RESULTS AND CONCLUSION： All patients in the two groups were followed up for 13 months on average （ranged from 10 to 37 months）. The incisions in the two groups were stage I healing. One case in the experimental group occurred cage displacement, but no obvious syndromes were detected. No significant difference in the effective rate after operation, hospital stay, and volume of drainage was detected （P 〉 0.05）. The operative time and bleeding volume in experimental group were better than those in the control group （P 〈 0.05）. ODI and JOA scores were significantly improved after treatment when compared with preoperative ones in the two groups （P 〈 0.05）, but no significant difference was visible between the two groups （P 〉 0.05）. The effectiveness of lateral lumbar interbody fusion with single cage and single cage combined with unilateral pedicle screw fixation for single-level degenerative lumbar diseases was similar. However, the former has the advantages of less invasion and quick recovery.

关 键 词：植入物 脊柱植入物 腰椎 退行性疾病 椎间融合术 单椎间融合器 椎间融合 钉棒内固定 

分 类 号：R318[医药卫生—生物医学工程]