后路椎间盘镜下单个可膨胀融合器固定融合术治疗腰椎退行性疾病的远期疗效分析  

Long-term efficacy of intervertebral fusion using single BTwin expandable spinal spacer through microendoscopic approach for lumbar degenerative disease

作　　者：何二兴[1] 刘成伟[1] 尹知训[1] 崔基浩[2] 刘超杰[1] 石中玉[1] 

机构地区：[1]广州医科大学附属第一医院广州骨科研究所,广东广州510120 [2]广州医科大学附属第四医院骨外科,广东广州510182

出　　处：《中国内镜杂志》2014年第10期1009-1013,共5页China Journal of Endoscopy

摘　　要：目的探讨后路椎间盘镜下使用单个可膨胀融合器（B-Twin ESS）固定融合术治疗腰椎退行性疾病的远期临床疗效。方法回顾性分析2007年2月-2010年1月由同一术者完成的21例共22个间隙使用单个B-Twin ESS固定融合术的病例,随访38-64个月,平均50个月,分析术前与术后随访时的JOA评分和椎间隙高度变化,用Suk标准评估椎间隙融合情况。结果 21例患者术前JOA评分为（11.6±2.9）分,末次随访为（26.6±1.5）分,末次随访时的JOA改善率为64.7%-94.4%,平均为86.4%,疗效均达到显效;术前病变椎间隙高度为（9.5±1.5）mm,术后1周为（11.5±1.3）mm,术后6个月为（10.0±1.4）mm,末次随访为（9.4±1.7）mm,术后6个月与末次随访比较差异有显著性（P〉0.05）。9例（40.9%）达到坚固融合,13例（56.3%）达到可能融合,0例未融合患者。结论经后路椎间盘镜下使用单个B-Twin ESS固定一个椎节治疗腰椎退行性疾病远期症状改善率好,但融合率有待提高。【Objective】To investigate long-term efficacy of interbody fusion using single B-Twin ESS through microendoscopic approach for lumbar degenerative disease.【Methods】A retrospective analysis was made on data of21 cases or 22 disc levels underwent fusion using a single B-Twin ESS by a same surgeon from Feb. 2007 to Jan.2010. The follow-up time ranged from 38 to 64 months and averaged 50 months. JOA were scored preoperatively and postoperatively and the disc height were measured at every follow-up. Healing state of the bone graft in the disc space was evaluated by Suk＇s criteria.【Results】JOA score were（11.6±2.9） preoperatively and（26.6±1.5） at final follow-up, respectively, JOA improvement rate was 64.7% -94.4%, the average was 86.4%, improvement was markedly effective postoperatively in all 21 cases at the final follow-up; The average disc height was（9.5±1.5） mm preoperatively,（11.5±1.3） mm at 1 week postoperatively,（10.0±1.4） mm at 6 months postoperatively and（9.4±1.7）mm at final follow-up, respectively, and the difference between the disc height at 6 months postoperatively and at final follow-up was significant（P 〉0.05）. Solid union occurred in 9 cases（40.9%） and probable union in 13 cases（56.3%）, None nonunion case was found by Suk＇s criteria. 【Conclusion】The long-term efficacy was satisfied interms of pain relieve for lumbar degenerative disease with fusion using single B-Twin ESS through microendoscopic approach, but the solid fusion rate needs to be improved.

关 键 词：腰椎退行性疾病 可膨胀融合器 后路椎间盘镜 

分 类 号：R681.5[医药卫生—骨科学]