CBT螺钉技术治疗骨质疏松腰椎退变性疾病的疗效分析  

Effect analysis of cortical bone trajectory screw for osteoporotic lumbar degenerative disease

作　　者：张寿强 窦永峰[2] 李建军[3] 胡鹏[2] 付国勇[4] 邢建强[2] 王光林[2] 耿晓鹏[2] ZHANG Shouqiang;DOU Yongfeng;LI Jianjun;HU Peng;FU Guoyong;XING Jianqiang;WANG Guanglin;GENG Xiaopeng(Department of Orthopedics,Qingyun People's Hospital,Dezhou 253700,P.R.China;Department of Orthopaedics,Binzhou Medical University Hospital;Department of Emergency,Binzhou Medical University Hospital;Department of Pediatric Surgery,Binzhou Medical University Hospital)

机构地区：[1]庆云县人民医院骨科,德州253700 [2]滨州医学院附属医院脊柱外科 [3]滨州医学院附属医院急诊科 [4]滨州医学院附属医院儿外科

出　　处：《滨州医学院学报》2019年第4期263-266,共4页Journal of Binzhou Medical University

基　　金：山东省医药卫生科技发展计划项目(2013WS0300)

摘　　要：目的应用皮质骨通道(Cortical bone trajectory,CBT)螺钉技术进行椎体间融合是一种较新的技术,本研究对CBT螺钉技术在治疗骨质疏松腰椎退变性疾病中的初期临床疗效进行评价。方法回顾性分析我院2015—2018年应用CBT螺钉技术进行椎间融合术治疗20例骨质疏松腰椎退变性疾病患者的临床资料。记录并分析患者年龄、手术时间、术中失血量、神经损伤情况、住院时间,术前、术后随访Oswestry功能障碍指数(Oswestry disabiliby index,ODI)、视觉模拟评分(Visual Analogue Scale/Score,VAS)、椎间融合率。结果平均手术时间183.2 min,平均术中失血量375.7 mL,平均住院时间4.56天。随访时间16~24个月,平均19.2个月,100%的病人获得融合。术后ODI和VAS评分数值较术前减小,并有统计学意义。结论在治疗骨质疏松腰椎退变性疾病时,CBT螺钉有更强的抗拔出力,能够获得可靠的固定,临床疗效满意,创伤更小,是一种安全、可靠、微创的置钉方法。Objective The aim of this study was to evaluate the outcomes of cortical bone trajectory(CBT)screws in the posterior lumbar fusion surgery of lumbar disease with osteoporosis by a retrospective study,a relatively new technique.Methods This is a retrospective cohort study.All patients that underwent circumferential lumbar interbody fusion with CBT screws in our hospital from 2015 to 2018 were reviewed.Patient age,clinical outcome with visual analogue scale(VAS)and Oswestry Disability Index(ODI),operative blood loss,hospital stay and the fusion rate were evaluated.Results All patients obtained follow-up 16 to 24 months postoperative,with an average of 19.2 months.Oswestry Disability Indexes and Visual Analogue Scores improved significantly at 3 months postoperative.Mean procedural time was 183.2 min.The mean operative blood loss was 375.7 mL.The mean hospital stay was 4.56 days.The fusion was obtained in 100%of cases.Mean ODI and VAS index postoperative improved with statistical significance.Conclusion The use of cortical bone trajectory(CBT)screws for interbody fusion is safe and effective to patients with osteoporosis.While the technique has less trauma,shorter operative time,hospital stays and good fusion rate.

关 键 词：皮质骨轨道 皮质骨螺钉 腰椎椎间融合 脊柱融合 脊柱固定 

分 类 号：R687.3[医药卫生—骨科学]