腰椎后路单节段融合与非融合固定的对比分析  

Posterior single segment fusion or non-fusion in treatment of lu mbar spinal disease: a comparative study

作　　者：卫秀洋[1] 董卫星[1] 陈勇忠[1] 王金星[1] 黄哲[1] 邹仪强 

机构地区：[1]南京军区福州总医院476临床部骨科,福建福州350002

出　　处：《东南国防医药》2015年第1期35-37,共3页Military Medical Journal of Southeast China

摘　　要：目的：比较融合与非融合术治疗腰椎单节段退变性疾病的临床疗效及其对相邻节段的影响。方法2011年5月－2012年6月，收集49例，按手术方法不同分两组，观察组21例使用弹性棒非融合固定术，对照组28例椎间融合固定术。采用疼痛视觉模拟评分法（ visual analog scale ，VAS）评价临床疗效，并通过X线片测量腰椎各间隙高度。结果所有病例均随访16～34个月，平均26．7个月，两组末次随访时VAS评分较术前都明显降低，差异有统计学意义（P＜0．05）。两组术后1周时VAS评分差异无统计学意义（P＞0．05）。观察组末次随访时上、下位节段椎间隙高度与术前比较退变不显著，差异不具有统计学意义（P＞0．05）；对照组上、下位节段椎间隙高度末次随访时与术前比较减少明显，差异具有统计学意义（P＜0．05）。结论融合与非融合固定治疗单间隙腰椎退变性都取得较好的临床疗效，非融合术会降低相邻节段退变的发生。Objective To compare the treatment effects on posterior single segment fusion and non-fusion in lumbar spinal disease, and to evaluate their influence on adjacent segments .Methods From May 2011 to June 2012, a total of 49 cases of degen-erative lumbar spinal disorders were treated .21 patients undergoing non-fusion were classified as study group and 28 patients undergo-ing conventional fusion were as controls .The clinical effect was evaluated by visual analogue scale （ visual analog scale , VAS） .The intervertebral height was measured by X-ray film.Results All patients were followed up 16-34 months （mean, 26.7 months）.The VAS score was significantly decreased compared with preoperative last follow-up （P〈0.05）.No significant difference of VAS score was found in two groups in early stage （P〉0.05）.In non-fusion group, there was no statistical difference in the intervertebral height of the adjacent segment between the last follow up postoperation and preoperative （P〉0.05）.In fusion group, the difference was sig-nificant （P〈0.05）.Conclusion Both fusion and non-fusion fixation have satisfying effects in treatment of degenerative lumbar spi-nal disorder .Non-fusion fixation could reduce adjacent segment degeneration .

关 键 词：腰椎间盘突出 腰椎管狭窄 融合 非融合 邻近节段退变 

分 类 号：R473.6[医药卫生—护理学]