皮质骨通道螺钉与椎弓根螺钉行腰椎间融合术的疗效比较  

Comparison results between cortical bone trajectory screw and conventional pedicle screw in posterior lumbar interbody fusion for single-segment degenerative lumbar disease

作　　者：王灿亚[1] 袁宏伟[1] 田志红 WANG Can-ya, YUAN Hong-wei, TIAN Zhi-hong(Dept of Orthopaedic Surgery, the 159th Hospital of PLA, Zhumadian, Henan 463000, China)

机构地区：[1]解放军第159医院骨外科,河南驻马店463000

出　　处：《临床骨科杂志》2018年第4期444-447,共4页Journal of Clinical Orthopaedics

摘　　要：目的比较皮质骨通道螺钉(CBTS)与椎弓根螺钉行腰椎后路椎间融合术(PLIF)治疗单节段腰椎退变性疾病的手术特点及临床疗效。方法对97例单节段腰椎退变性疾病患者根据内固定方式不同分为通道螺钉组(采用CBTS行PLIF,51例)和椎弓根螺钉组(采用椎弓根螺钉行PLIF,46例)。记录两组患者手术时间、术中出血量、术后引流量、双氯芬酸钠使用总量、术后住院天数、卧床时间及并发症情况;比较术后12个月腰痛VAS评分、ODI及椎间融合率。结果患者均获得12个月随访。手术时间、术中出血量、术后引流量、双氯芬酸钠使用总量、卧床时间、住院时间通道螺钉组均少于椎弓根螺钉组(P<0.001,P<0.05);两组并发症发生率、术后12个月腰痛VAS评分、ODI及椎间融合率比较差异均无统计学意义(P>0.05)。结论采用腰椎后路椎弓根螺钉与CBTS行PLIF治疗单节段腰椎退变性疾病,均可获得满意的椎间融合率和临床疗效。CBTS行PLIF有术中出血量少、肌肉损伤小、患者痛苦小等优点。Objective To compare the surgery features and clinical effects of cortical bone trajectory screw（ CBTS）with conventional pedicle screw for lumbar interbody fusion（ PLIF） in the treatment of single-segment lumbar degenerative disease. Methods The 97 patients with single-segment lumbar degenerative disease were divided into trajectory screw group（ using CBTS for PLIF,51 cases） and pedicle screw group（ using pedicle screw for PLIF,46 cases）. The operative time,intraoperative blood loss,postoperative drainage,total volume of diclofenac sodium,length of hospital stays,bed time and complications were recorded; The VAS,ODI and postoperative intervertebral fusion rate at 12 months after operation were compared between two groups. Results All of the 97 patients were followed up for 12 months. The patients in the trajectory screw group had significantly less operative time,intraoperative blood loss,postoperative drainage,total volume of diclofenac sodium,bed time and length of hospital stay,when compared with those patients in pedicle screw group（ P 0. 001,P 0. 05）. There were no significant difference in the incidence of perioperative complications,ODI and interbody fusion rate at 12 months postoperation（ P 0. 05）. Conclusions For the single-segment degenerative lumbar disease,the use of CBTS or conventional pedicle screw for PLIF,both can obtain satisfactory clinical function and interbody fusion rate. CBTS has the advantage of less blood loss,less intraoperative muscle damage,less perioperative pain.

关 键 词：腰椎退变性疾病 皮质骨通道螺钉 椎弓根螺钉 后路腰椎间融合术 融合率 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]