椎弓根螺钉内固定联合后外侧植骨融合术治疗腰椎滑脱症患者临床效果及对术后疼痛和BFS评分影响  

Effects of Pedicle Screw Internal Fixation Combined with Posterolateral Fusion on the Clinical Efficacy,Postoperative Pain and BFS Score of Patients with Lumbar Spondylolisthesis

作　　者：张晓越 王小红 刘康 李毓吉 ZHANG Xiao-yue;WANG Xiao-hong;LIU Kang;LI Yu-ji(The First Department of Orthopedic Surgery,Qingyang People's Hospital,Qingyang,Gansu 745000,China;Outpatient Department,Qingyang Second People's Hospital,Qingyang,Gansu 745000,China)

机构地区：[1]庆阳市人民医院骨一科,甘肃庆阳745000 [2]庆阳市第二人民医院门诊部,甘肃庆阳745000

出　　处：《临床误诊误治》2020年第11期69-74,共6页Clinical Misdiagnosis & Mistherapy

基　　金：甘肃省科技计划外项目(2020-CX-1001)。

摘　　要：目的探讨椎弓根螺钉内固定联合后外侧植骨融合术治疗腰椎滑脱症患者的临床效果及对术后疼痛和BFS评分的影响。方法选取腰椎滑脱症100例,根据手术方式不同将其分为研究组及对照组两组各50例。研究组采取椎弓根螺钉内固定联合后外侧植骨融合术治疗,对照组仅采取椎弓根螺钉内固定术治疗。比较两组术后6个月临床效果,术前及术后6个月视觉模拟评分法(VAS)、BFS(beaujon functional score)评分,术后3和6个月植骨融合情况,术前及术后6个月椎间隙高度、滑脱率,术后6个月复位丢失率和椎间隙高度丢失率,以及手术相关并发症发生情况。结果术后6个月,临床总有效率研究组为98.00%,对照组为86.00%,研究组临床总有效率高于对照组,差异有统计学意义(P<0.05)。术前,两组VAS及BFS评分比较差异无统计学意义(P>0.05)。术后6个月,两组VAS评分均较术前降低,BFS评分均较术前升高;且研究组VAS评分低于对照组,BFS评分高于对照组,差异均有统计学意义(P<0.01)。术后3个月,两组植骨融合率比较差异无统计学意义(P>0.05)。术后6个月,两组组内植骨融合率均较术后3个月升高,且研究组植骨融合率高于对照组,差异有统计学意义(P<0.05或P<0.01)。术前,两组椎间隙高度和滑脱率比较差异无统计学意义(P>0.05)。术后6个月,两组椎间隙高度均较术前升高,滑脱率均较术前降低;研究组椎间隙高度高于对照组,滑脱率、复位丢失率和椎间隙高度丢失率低于对照组,差异有统计学意义(P<0.01)。研究组手术相关并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论椎弓根螺钉内固定联合后外侧植骨融合术治疗腰椎滑脱症患者可缓解疼痛、提高腰椎稳定性,且维持滑脱矫正功效优于单纯椎弓根螺钉内固定术治疗,临床治疗效果较佳。Objective To explore the clinical effect of pedicle screw internal fixation combined with posterolateral fusion in the treatment of patients with lumbar spondylolisthesis and its influence on postoperative pain and BFS score.Methods A total of 100 patients with lumbar spondylolisthesis were selected and divided into research group(n=50)and control group(n=50)according to different surgical methods.The research group was treated with pedicle screw internal fixation combined with posterolateral fusion,and the control group was treated with pedicle screw internal fixation.The clinical effects at 6 months after surgery,visual analogue scale(VAS)score and beaujon functional score(BFS)before surgery and at 6 months after surgery,bone graft fusion at 3 and 6 months after surgery,as well as height of the intervertebral space,the rate of spondylolisthesis,the loss rate of postoperative reduction and the loss rate of height of intervertebral space at 6 months after operation,and the incidence of surgery-related complications were compared between the two groups.Results At 6 months after the operation,the total effective rate was 98.00%in the research group,which was higher than 86.00%in the control group(P<0.05).Before operation,there was no significant difference in VAS and BFS scores between the two groups(P>0.05).At 6 months after operation,the VAS scores of the two groups were lower than those before operation,and the BFS scores were higher than those before the operation.And the VAS score of the research group was lower than that of the control group,and the BFS score was higher than that of the control group(P<0.01).At 3 months after operation,there was no significant difference in fusion rate between the two groups(P>0.05).The fusion rate of the two groups at 6 months after surgery was significantly higher than that at 3 months after surgery,and the fusion rate in the research group was higher than that in the control group(P<0.05 or P<0.01).Before operation,there was no difference in the height of the intervertebra

关 键 词：腰椎滑脱 植骨融合术 椎弓根螺钉内固定 腰椎间隙高度 BFS评分 疼痛 

分 类 号：R681.57[医药卫生—骨科学]