减压碎骨块行椎间融合治疗退变性腰椎不稳并狭窄病例对照研究  

Case control study of interbody fusion with simple decompression bone block in treating degenerative lumbar instability and spinal stenosis

作　　者：孟凡志[1] 高芹[1] 王兴龙[1] 何勇[1] 

机构地区：[1]临沂市中医医院骨伤二科,山东临沂276002

出　　处：《中国骨伤》2017年第5期400-405,共6页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨自体减压碎骨块在椎间融合中的价值。方法 :2014年4月至2015年5月,采用后路全椎板减压钉棒固定单侧改良TLIF入路椎间融合治疗退变性腰椎不稳并狭窄42例,男18例,女24例,其中24例单纯用自体减压碎骨块为椎间融合材料(治疗组),18例用cage加自体骨作为椎融合材料(对照组)。分析两组临床资料情况,对比两种治疗方式的骨性愈合时间、椎间融合率、椎间隙高度以及疗效的差异。结果:42例患者均获得随访,时间12~24个月,平均16个月。两组患者在发病年龄、性别比例、腰椎不稳程度及随访时间上差异无统计学意义(P>0.05);两组患者在临床疗效、椎间高度丢失情况、椎间融合率的差异也无统计学意义(P>0.05)。结论:利用减压碎骨块行椎间融合治疗退变性腰椎不稳并狭窄,术后融合率高,椎间隙高度维持良好,临床疗效满意,设计科学合理,并发症少,为治疗退变性腰椎管不稳并椎管狭窄提供了经济、实用、临床疗效确切的治疗方法。Objective：To explore the value of the serf-decompression bone block in interbody fusion. Methods：From April 2014 to May 2015,42 patients with degenerative lumbar instability and spinal stenosis were treated by posterior vertebral lamina decompression and pedicle nail-rod fixation and unilateral modified transforaminal lumbar interbody fusion,including 18 males and 24 females. The treatment group had 24 cases with autologous pure decompression bone block as single interbody fusion material and the control group had 18 cases with cage and autologous bone as interbody fusion material. Clinical data, bone healing time, interbody fusion rate, intervertebral height and curative effect were analyzed in two groups. Results ： All the patients were followed up for 12 to 24 months with an average of 16 months. There was no significant difference in age ,sex ra- tio, degree of lumbar instability, or follow-up time between two groups （P〉0.05） ; and there was no significant difference in curative effect,intervertebral height loss, or interbody fusion rate between two groups （/0〉0.05）. Conclusion： Using self-decompression bone block fusion can get high fusion rate,maintain good intervertebral height, obtain satisfactory curative effect. Its design was scientific and reasonable with less complication, which provide an effective, economic, and practical method for de- generative lumbar instability and spinal stenosis.

关 键 词：腰椎不稳 椎间融合 碎骨块 临床疗效 

分 类 号：R681.5[医药卫生—骨科学]