单枚椎间融合器结合足量椎间植骨在腰椎融合中的中远期疗效分析  

Analysis on the mid / long-term clinical effect of single lumbar interbody fusion combinedwith large volume of bone graft in the treatment of spinal fusion

作　　者：周仁实 洪锦向 何二兴 

机构地区：[1]广东省阳春市人民医院骨外科,529600

出　　处：《齐齐哈尔医学院学报》2015年第9期1310-1312,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨单枚椎间融合器结合足量椎间植骨在腰椎融合中的中远期疗效。方法回顾我院2001年10月至2010年1月行腰椎管减压融合术并有完整资料的85例病例。所有患者均在完成椎弓根螺钉内固定、椎管减压、椎间盘切除后,向间隙内植入自体骨粒约7~16 ml,再从后斜向前置入l枚椎间融合器行融合术。随访时观察固定节段融合情况,测量并比较术后2周与术后18个月时的椎间隙高度。结果随访18~112个月,平均42个月。根据Nakai评分标准,优良率为84.7%。各病例随访至术后18个月时,72例患者腰椎融合术后椎弓根钉、棒系统无松动,融合的椎间隙高度与术后2周时无差异;发现有12例患者术后椎弓根钉、棒系统有松动,但无滑脱发生,椎间隙高度较术后2周时略减低,但统计学上无显著性差异;1例椎弓根钉断裂。随访病例均已获椎间融合,融合率100%。结论使用椎弓根螺钉加单枚椎间融合器进行腰椎融合手术可以减少术后内固定失效和低融合率问题,结合足量减压骨回植可以达到牢固椎间融合的作用。Objective This paper was to investigate the mid/long -term effect of lumbar interbody fusion combined with large volume of bone graft in the treatment of spinal fusion.Methods 85 consecutive patients needed Lumbar spinal canal decompression and interbody fusion during October 2001 and January 2010were retrospectively studied,they were all treated surgically with pedicle screw system and single cage, about 7-16 ml of decompression bone chips were inserted into interbody space.And then, a single cage was placed obliquely into the lumbar interbody space.The height of interbody space was noted at 2 weeks and 18 months postoperatively and follow -up period respectively.Results The follow -up period was 18 -112 months, averaged 42 months.The excellent and good rates was 84.7% according to Nakai criterion.Fixation system fixed firmly in 72 patients and there were no loss of space height after 18 months of follow-up.There were slight loss of space height at 18 months compared with that at 2 weeks postoperatively but had no statistical significance and no slippage occurred in 12 patients.Pedicle screw breakage happened in one patient ;Union occurred in all the patients and the total fusion rate was 100%.Conclusions Lumbar treated surgically with pedicle screw system and single cage may decrease the morbidity such as fixation failure and none union postoperatively.Single cage with pedicle screw system fixes firmly, which combined with graft from decompression bone chips can provide fusion effectively.

关 键 词：腰椎 椎弓根钉系统 融合器 椎间融合 

分 类 号：R681.5[医药卫生—骨科学]