椎间隙环Cage周围270°自体骨回植术对腰椎融合术后椎体融合率及疗效的影响  

Effect of 270°autogenous bone replantation around the intervertebral cage on vertebral fusion rate and efficacy after lumbar fusion

作　　者：吴昊[1] 于海洋[1] 翟云雷[1] 梁成民[1] 崔西龙[1] WU Hao;YU Hai-yang;ZHAI Yun-lei;LIANG Cheng-min;CUI Xi-long(Department of Orthopedics,Fuyang People's Hospital,Fwyang,Anhui 236000,China)

机构地区：[1]阜阳市人民医院骨科,安徽阜阳236000

出　　处：《中华全科医学》2021年第9期1488-1491,共4页Chinese Journal of General Practice

基　　金：安徽省科技厅重点研究与开发计划项目(1704a0802159);阜阳市卫健委科研项目(FY2019-024);阜阳市科技局科研项目(FK2020081022);蚌埠医学院自然科学重点项目(BYKY2019226ZD)。

摘　　要：目的探讨椎间隙内环Cage周围270°自体骨回植术对行腰椎融合术患者的疗效及椎体融合率情况的影响。方法选取2017年6月—2019年12月在阜阳市人民医院行腰椎后路减压椎弓根螺钉内固定椎间Cage置入融合的腰椎管狭窄症患者共64例作为研究对象。按随机数字表法将患者分为对照组和观察组,每组32例。观察组椎间隙融合采用环Cage周围270°自体骨植骨,对照组融合采用椎间隙前缘植骨结合填充自体骨的Cage。2组病例分别于术后拔除引流管复查X线,术后12个月复查腰椎动力位片及CT,通过Suk法及Siepe法对比2组患者椎间融合率、椎间隙高度变化,评估不同椎间融合方式下腰椎椎间融合的效果以及患者的临床疗效。结果术后患者随访12~18个月,术后1周、12个月复查,术后12个月见观察组融合率高于对照组,差异有统计学意义(均P<0.05);术后1周、术后1年椎间隙高度及椎间孔高度均较术前有明显改善,差异有统计学意义(均P<0.05)。结论通过对比提示椎间隙内环Cage周围270°自体骨回植术,比单纯椎间Cage植入植骨融合率高,因此建议Cage植入前后在椎间隙内植入同种自体骨将Cage包裹,更有利于椎间隙的融合。Objective To investigate the effect of 270°autologous bone replantation around the cage of the intervertebral space on the efficacy of lumbar fusion and the fusion rate of the vertebral body.Methods A total of 64 patients with lumbar spinal stenosis who underwent posterior decompression of the lumbar spine and pedicle screw internal fixation with interbody cage placement and fusion in our hospital from June 2017 to December 2019 were selected as the research objects.According to the random number table method,the patients were divided into control group and observation group,with 32 cases each group.The observation group was given 270°autogenous bone graft around the ring cage,whilst the control group was given anterior edge bone graft of the intervertebral space combined with the cage filled with autogenous bone.After the drainage tube was removed,the two groups of patients were re-examined by X-ray,and the lumbar dynamics and CT were re-examined 12 months after the operation.The Suk and Siepe methods were used to compare the intervertebral fusion rate and the change of intervertebral space height in both groups to evaluate different vertebrae,the effect of lumbar intervertebral fusion and the clinical curative effect of patients under the interfusion mode.Results The patients were followed up for 12 to 18 months,and re-examinations were performed at 1 week and 12 months after the operation.The fusion rate in the observation group was higher than that in the control group at 12 months after the operation.The height of the intervertebral space and the height of the intervertebral foramen were significantly improved at 1 week and 1 year after the operation,and the difference was statistically significant(all P<0.05).Conclusion The comparison suggests that the 270°autologous bone replantation around the cage in the intervertebral space has a higher fusion rate than the simple intervertebral cage implantation.Therefore,the same kind of autologous bone should be implanted in the intervertebral space before and aft

关 键 词：腰椎融合术 Cage周围植骨 腰椎管狭窄症 

分 类 号：R687.4[医药卫生—骨科学] R681.57[医药卫生—外科学]