皮质骨通道螺钉技术在腰椎邻椎病中的应用  

Application of cortical bone trajectory screw technique for treating lumbar adjacent segment disease

作　　者：任东林 陈宇[2] 陈德玉[2] 焦鲲[1] 李坤 宋鑫[1] REN Dong-lin;CHEN Yu;CHEN De-yu;JIAO Kun;LI Kun;SONG Xin(Dept of Spine Surgery,Pudong New Area People′s Hospital of Shanghai,Shanghai 201200,China)

机构地区：[1]上海市浦东新区人民医院脊柱外科,上海201200 [2]第二军医大学附属长征医院脊柱外科,上海200003

出　　处：《临床骨科杂志》2020年第4期510-514,共5页Journal of Clinical Orthopaedics

基　　金：上海市浦东新区卫生系统学科带头人培养计划(编号:PWRd2017-08)。

摘　　要：目的探讨皮质骨通道(CBT)螺钉治疗腰椎融合术后邻椎病(ASD)的临床应用价值。方法分析27例腰椎融合术后发生单节段ASD的患者资料,患者均行二次手术,两次手术间隔时间为4.0~8.6年。手术采用CBT螺钉固定结合椎间植骨融合技术。疼痛症状及神经功能恢复情况采用VAS评分和ODI评估,利用术后腰椎X线及CT检查评估内置物位置及植骨融合情况。结果手术时间85~120 min,术中出血量180~400 ml。患者均获得随访,时间12~18个月。术后12个月,VAS评分和ODI均较术前明显改善,差异有统计学意义(P<0.05),随访过程中无并发症发生。结论CBT螺钉治疗腰椎ASD患者手术创伤小,临床疗效满意。Objective To investigate the clinical value of cortical bone trajectory(CBT)screw in the treatment of adjacent segment disease(ASD)after lumbar fusion.Methods The data of 27 patients with ASD after lumbar fusion were analyzed.The interval time between two operations ranged from 4.0 years to 8.6 years.These patients were treated with CBT screw technique and intervertebral bone grafting fusion.Clinical results were evaluated by the VAS for back and leg pain,as well as ODI score for nerve function recovery.The internal fixation position and bone fusion were evaluated by postoperative X-ray and CT examination.Results Surgical time ranged from 85 min to 120 min,and intraoperative blood volume ranged from 180 ml to 400 ml.All cases got follow-up of 12~18 months.At 12 months postoperation,the VAS and ODI were improved significantly,compared with the preoperative(P<0.05),without related complications.Conclusions CBT screw technique is useful in the treatment of ASD after lumbar fusion,with good clinical results and minimal trauma.

关 键 词：腰椎融合术 皮质骨通道 邻椎病 

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