单侧椎弓根钉联合椎体间融合器选择性治疗退行性腰椎病疗效观察  

Curative effectiveness of unilateral pedicle screw with cage fusion between vertebrae in selective treatment of degenerative lumbar disease

作　　者：周少怀 方红育 李宏亮 范明宇 卞峰 任敏 

机构地区：[1]武汉市第三医院骨科,430061

出　　处：《中华实验外科杂志》2015年第9期2283-2285,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 探讨腰椎后路单侧椎弓根螺钉联合椎体间融合器（Cage）选择性治疗退行性腰椎病的临床疗效.方法 分析49例腰椎退行性疾病患者,术前影像学资料明确患者存在椎间盘突出和（或）单侧侧隐窝狭窄,临床表现以下腰部疼痛为主,伴或不伴一侧肢体麻木疼痛症状,经保守治疗无效后,采用经后路单侧椎弓根螺钉内固定联合Cage椎间植骨融合手术进行治疗,其中男24例,女25例,年龄26 ～ 75岁（平均54.2岁）,病程0.5 ～3.0年.使用Oswestry（ODI）功能障碍指数和日本骨科协会（JOA）评分法评估术后疗效,依据SUK法对术后脊柱融合情况进行评估.结果 所有患者手术前后Oswestry功能障碍指数之间比较差异有统计学意义（P＜0.05）,根据日本JOA评分法评估优36例（73.4％）、良9例（18.4％）、可2例（4.1％）、差2例（4.1％）,依据SUK标准证实本组病例椎体间植骨融合率为91.8％.有2例患者术后复查出现内固定螺钉螺栓松脱,但内固定椎弓根钉无松动断裂脱出,经调整更换尾帽并行支具固定3个月后复查未见松动,患者肢体症状均明显改善.结论 单侧椎弓根钉联合Cage椎体间融合选择性治疗退行性腰椎病手术时间短、创伤小、临床疗效良好.Objective To investigate the curative effectinvess of the lumbar posterior unilateral pedicle screw with cage fusion between vertebre in selective treatment of degenerative lumbar disease.Methods Forty-nine patients with lumbar degenerative disease,preoperative imaging data verified that patients with Intervertebral disc herniation and （or） unilateral lateral recess stenosis,and clinical manifestations mostly were waist pain,with or without symptoms of one side numbness and pain,after conservative treatment is invalid,utilized surgery treatment of the posterior unilateral pedicle screws fixation with cage of intervertebral bone graft fusion,24 cases of men,women,25 cases,aged 26 to 75 years old （average 54.2 years）,0.5-3.0 years duration of the disease.Use Oswestry index （ODI） dysfunction and Japanese Orthopaedic Association （JOA） score method to evaluate the postoperative curative effect,on the basis of SUK method to evaluate the postoperative spinal fusion.Results The difference of preoperative and postoperative Oswestry disability index of all patients was statistically significant,according to Japanese JOA score method,optimal effect were 36 cases （73.4％）,well effect were 9 cases （18.4％）,ordinary effect were 2 cases （4.1％）,poor effect were 2 cases （4.1％）,according to the SUK standard confirmed that vertebral body bone graft fusion rate was 91.8％.2 patients appeared postoperative review set screw bolts loose,but internal fixation of pedicle screw without loose or breaking out,adjusted to replace the tail cap in parallel and with a fixed march did not appear loose again,the limb symptoms were significantly improved.Conclusion Unilateral pedicle screw with Cage fusion between vertebral in selective treatment of degenerative lumbar disease has the advantage of shorter operation time,less trauma,and well clinical curative effect.

关 键 词：腰椎退行性疾病 单侧椎弓根钉内定 Cage椎间融合 

分 类 号：R681.5[医药卫生—骨科学]