皮质骨轨迹螺钉结合微创后路中线融合技术在骨质疏松患者中的应用  

Application of Cortical Bone Track Screw Combined with Minimally Invasive Midline Lumbar Fusion in Patients with Osteoporosis

作　　者：温俭[1] 吴峰[1] 陈文明[1] 康健 胡芯源 WEN Jian;WU Feng;CHEN Wenming;KANG Jian;HU Xinyuan(Pingxiang People’s Hospital,Pingxiang 337000,China)

机构地区：[1]江西省萍乡市人民医院,江西萍乡337000

出　　处：《中国医学创新》2020年第28期10-14,共5页Medical Innovation of China

基　　金：江西省卫健委科技计划项目(20202064)。

摘　　要：目的:探究皮质骨轨迹螺钉结合微创后路中线融合技术应用于骨质疏松患者治疗中的临床效果。方法:选取2018年6月-2019年6月到本院治疗的41例骨质疏松患者患者作为此次研究的研究对象。以掷硬币的方式进行随机分组,将患者分为参照组(20例)和治疗组(21例)。参照组采取椎弓根螺钉结合经椎间孔椎体间融合(transforaminal lumbar interbody fusion,TLIF)技术治疗;治疗组采取皮质骨轨迹螺钉结合微创后路中线融合技术(midline lumbar fusion,MIDLF)治疗。记录患者术前、术后一周及术后半年VAS评分、JOA评分、JOA评分好转率(RIS)、手术切口长度、手术时间、出血量、术后并发症发生情况、术后半年内固定松动及椎间融合率。结果:两组患者术前VAS评分、JOA评分对比,差异均无统计学意义(P>0.05)。术后一周,两组下肢VAS评分对比,差异无统计学意义(P>0.05),治疗组术区VAS评分明显低于参照组(P<0.05),治疗组JOA评分、RIS明显均优于参照组(P<0.05)。术后半年,两组患者下肢VAS评分、术区VAS评分对比,差异均无统计学意义(P>0.05),JOA评分和JOA评分改善率治疗组高于参照组,但差异均无统计学意义(P>0.05)。治疗组手术切口长度、手术时间、出血量均明显优参照组(P<0.05)。患者均得到随访,随访时间为半年,参照组出现1例切口浅层感染,治疗组未见并发症;两组内固定松动以及椎间融合率对比,差异均无统计学意义(P>0.05)。结论:皮质骨轨迹螺钉结合微创后路中线融合技术应用于骨质疏松患者治疗中的临床效果较好,可明显改善患者的关节疼痛和腰椎功能,该治疗方式手出血量较少且手术时间短,术后并发症较少,不易松动,且椎间融合率较高,临床可推广使用。Objective:To investigate the clinical effect of cortical bone track screw combined with minimally invasive midline lumbar fusion in the treatment of osteoporosis patients.Method:A total of 41 patients with osteoporosis who were treated in our hospital from June 2018 to June 2019 were selected as the study subjects.Randomized by coin toss,patients were divided into the reference group (20 cases) and the treatment group (21 cases).The reference group treated transforaminal lumbar interbody fusion (TLIF).The treatment group adopted cortical bone track screw combined with minimally invasive midline lumbar fusion (MIDLF).Before surgery,1 week and 6 months after surgery,the VAS score,JOA score,JOA score improvement rate (RIS),incision length,operation time,blood loss,postoperative complications,fixation loosening and intervertebral fusion rate of two groups were recorded.Result:There were no significant differences in preoperative VAS score and JOA score between the two groups (P>0.05).One week after the operation,there was no significant difference in VAS score between the two groups (P>0.05),VAS score in the operative area of the treatment group was significantly lower than that of the reference group (P<0.05),JOA score and RIS in the treatment group were significantly better than those of the reference group (P<0.05).Half a year after the operation,there were no significant differences in VAS score of lower limbs and VAS score of operative area between the two groups (P>0.05);the improvement rate of JOA score and JOA score in the treatment group were higher than those in the reference group,but there were no statistically significant differences (P>0.05).All patients were followed up for half a year,1 case of superficial incision infection occurred in the reference group,and no complications were observed in the treatment group,comparison of internal fixation loosening and intervertebral fusion rate between the two groups showed no statistically significant difference (P>0.05).Conclusion:The cortical bone trajectory

关 键 词：皮质骨轨迹螺钉 微创后路中线融合技术 骨质疏松 疼痛程度 腰椎功能 

分 类 号：R687.3[医药卫生—骨科学]