单节段脊柱退行性疾病患者应用后路腰椎椎体间植骨融合术治疗的临床效果  

The clinical effect of posterior lumbar intervertebral fusion and its effect on Harris score in patients with single segment degenerative spinal disease

作　　者：王磊[1] 麻松[1] 朱继超[1] 崔维[1] Wang Lei;Ma Song;Zhu Jichao;Cui Wei(Department of Spine Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院脊柱外科,100070

出　　处：《疑难病杂志》2020年第8期828-831,844,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：首都卫生发展科研专项项目(首发2016-1-4096)。

摘　　要：目的探究单节段脊柱退行性疾病患者应用后路腰椎椎体间植骨融合术治疗的临床效果。方法选取2017年10月—2019年1月首都医科大学附属北京天坛医院脊柱外科收治的单节段脊柱退行性疾病患者96例。按随机数字表法分为研究组与对照组,每组48例。对照组采用开放经椎间孔腰椎椎体间融合术治疗;研究组采取后路腰椎椎体间植骨融合术治疗。比较2组围术期临床指标,手术前后VAS与JOA评分,评估临床疗效。结果研究组手术优良率93.8%,高于对照组的72.9%,差异有统计学意义(χ^2=5.031,P=0.018);研究组手术时间、术中出血量、术后下床活动时间、住院时间及并发症各项围术期临床指标水平均优于对照组(t=3.510、17.667、23.064、39.239,χ^2=4.800,P<0.05);研究组术后1周VAS评分低于对照组,而JOA评分高于对照组(t=8.675、3.312,P<0.05);研究组生活质量评分高于对照组(t=14.818,P<0.01),2组Brantigan评分≥3分占比及植骨融合率比较差异无统计学意义(P>0.05)。结论对单节段脊柱退行性疾病患者采用后路腰椎椎体间植骨融合治疗,有助于临床指标的显著改善,降低患者术后疼痛,临床疗效得到显著提升,利于改善其生活质量水平,临床应用价值较高。Objective To investigate the clinical effect of posterior lumbar intervertebral fusion in patients with single segment degenerative spinal disease and its effect on Harris score Methods Ninety-six cases of single segment degenerative spinal disease from October 2017 to January 2019 were selected for this experiment.According to different surgical methods,they are divided into study group and control group.The control group was treated with open transforaminal lumbar interbody fusion;the research group was treated with posterior lumbar interbody fusion.The perioperative clinical indicators,VAS and JOA scores before and after operation,follow-up results and clinical efficacy were compared between the two groups.Results The excellent and good rate of operation in the study group was 93.8%higher than that in the control group 72.9%,and the difference was statistically significant(χ^2=5.031,P=0.018);the operation time,intraoperative blood loss,postoperative time to get out of bed,hospital stay and the perioperative clinical indicators of complications were lower than those of the control group(t=3.510,t=17.667,t=23.064,t=39.239,χ^2=4.800,P<0.05);the VAS score of the study group was lower than 1 week after operation The control group,and the JOA score was higher than the control group(t=8.675,3.312,P<0.05);the quality of life score of the study group was higher than the control group(t=14.818,P<0.01),the average follow-up time and bone graft fusion of the two groups There was no significant difference in the rate(P>0.05).Conclusion The use of posterior lumbar interbody fusion for the treatment of single-segment spinal degenerative diseases can help to significantly improve the clinical indicators,reduce postoperative pain,and improve the clinical efficacy and bone graft fusion rate.To improve its quality of life,the clinical application value is high.

关 键 词：单节段脊柱 退行性疾病 后路腰椎椎体间植骨融合术 临床效果 

分 类 号：R68[医药卫生—骨科学]