两种椎间植骨融合法在治疗腰椎滑脱症中的疗效观察  

Efficacy observation of two interbody fusion in the treatment of lumbar spondylolisthesis

作　　者：戴腾[1] 朱国兴[1] 陈鹏[1] 钱明权[1] 杜炜[1] 顾羊林[1] 

机构地区：[1]南京医科大学附属无锡第二医院骨科,江苏无锡214002

出　　处：《中国医药科学》2015年第22期185-188,共4页China Medicine And Pharmacy

摘　　要：目的比较自体椎板棘突碎骨植骨与髂骨植骨在后路椎间融合术治疗腰椎滑脱症中的临床疗效。方法将63例腰椎滑脱症患者随机分为研究组（A组,33例）和对照组自体髂骨椎间组（B组,30例）,研究组采用了腰椎后路切开椎弓根螺钉内固定＋自体椎板棘突碎骨植骨融合术,而对照组采用了腰椎后路切开椎弓根螺钉内固定＋髂骨植骨融合术,比较两组手术时间、出血情况、临床疗效、术前和术后手术节段椎间隙高度、植骨融合率及临床疗效。并于术前、术后3、6、12个月测定JOA（japanese orthopaedics association）评分。结果术后随访时间为12-36个月,平均（21.5±3.2）个月,研究组患者手术时间及手术过程中出血量均少于对照组,两组比较差异有统计学意义（P〈0.05）。A组椎间隙高度丢失（1.2±0.4）mm,B组椎间隙高度丢失（2.4±0.5）mm,两组椎间隙高度丢失差异有统计学意义（P〈0.05）;术后12个月,A组融合率为97.3%,B组融合率为98.4%,两组融合率差异无统计学意义（P〉0.05）;两组术前、术后JOA评分比较,差异有统计学意义,而两组之间JOA评分差异无统计学意义。结论自体回收骨回植的后路椎体间打压植骨融合术可作为治疗腰椎滑脱症的优化方法,较取髂骨快植入法创伤小,简单,经济。Objective To compare the clinical efficacy of spinous lamina autologous bone graft and iliac bone graft in the posterior interbody fusion of lumbar spondylolisthesis. Methods 63 cases with lumbar spondylolisthesis were randomly divided into a study group（group A,33 cases） and a control group with autogenous iliac intervertebral（group B,30 patients）,the study group received the incision posterior lumbar pedicle screw fixation and autogenous bone fusion surgery spinous lamina,while the control group received a fixed combined with iliac incision posterior lumbar interbody fusion with pedicle screws,operative time, blood,clinical the efficacy of preoperative and postoperative surgical segment disc height,fusion rate and clinical efficacy between the two groups were compared.And JOA（Japanese Orthopaedics Association） score in the preoperative and postoperative 6,12 months was measured. Results Postoperative follow-up time was 12-36 months, average（21.5±3.2） months,surgery time and study groups during surgery bleeding volume were less than the control group,the difference between the two groups was statistically significant（P〈0.05）.A group of disc height loss（1.2±0.4）mm,group B intervertebral height loss（2.4±0.5）mm,two intervertebral height loss difference was statistically significant（P〈0.05）;after December,A group fusion rate was 97.3%,group B fusion rate was 98.4%,the fusion rate between the two groups was not statistically significant（P〉0.05）;the two groups, postoperative JOA scores were significantly different between the two groups and no JOA score significant differences. Conclusion Autologous bone replantation of recovery weighed posterior vertebral bone grafting as treatment of lumbar optimization methods,faster than the iliac small law trauma implants,simple and economical.

关 键 词：腰椎滑脱症 植骨融合 内固定 后路 

分 类 号：R687.3[医药卫生—骨科学]