改良PLIF治疗骨量减少的腰椎间盘突出症的疗效及对术中出血量、植骨融合率的影响  

Effect of modified PLIF in the treatment of osteopenic lumbar disc herniation and on intraoperative blood loss and bone graft fusion rate

作　　者：王龙 冯骁 王海波 蒋健 袁泉 孟柏屹 赵德勇 王业华 WANG Long;FENG Xiao;WANG Hai-bo(Department of Orthopedics,Affiliated Hospital of Xuzhou Medical University,Xuzhou Jiangsu 221000,China)

机构地区：[1]徐州医科大学附属医院骨科,江苏徐州221000

出　　处：《临床和实验医学杂志》2021年第23期2538-2541,共4页Journal of Clinical and Experimental Medicine

基　　金：江苏省自然科学基金项目(编号:BK20161175)。

摘　　要：目的探讨改良腰椎后路椎间融合术(PLIF)治疗骨量减少的腰椎间盘突出症的疗效及对术中出血量、植骨融合率的影响。方法前瞻性选取2018年11月至2021年11月徐州医科大学附属医院骨科收治骨量减少腰椎间盘突出症患者107例为研究对象,按照随机数字表法分为观察组(n=54)和对照组(n=53)。观察组采用改良腰椎后路椎间融合术进行治疗,对照组采用传统后路椎弓根螺钉固定术进行治疗。比较两组患者临床疗效、术后1、3、6个月视觉疼痛模拟量表(VAS)评分、腰椎Oswestry功能障碍指数(ODI)评分、术中出血量、术后3、6个月植骨融合率及术后1、3、6个月椎间隙高度。结果观察组有效率94.44%,优于对照组的79.24%,差异有统计学意义(P<0.05)。观察组术后1、3、6个月VAS评分和ODI评分为(4.31±0.96)、(2.22±0.47)、(0.85±0.55)分和(20.45±5.31)、(11.12±3.63)、(7.52±2.32)分,均低于对照组[(4.89±0.79)、(2.97±0.38)、(1.45±0.86)分和(26.53±5.73)、(15.34±3.67)、(10.75±2.65)分],差异均有统计学意义(P<0.05)。观察组术中出血量(215.37±99.63)m L,少于对照组[(293.32±115.21)m L],差异有统计学意义(P<0.05)。观察组术后3、6个月植骨融合率为51.85%、79.63%,高于对照组(45.28%、69.81%),差异有统计学意义(P<0.05)。观察组术后1、3、6个月椎间隙高度为(11.81±1.26)、(10.92±0.96)、(9.84±0.78)mm,低于对照组[(12.61±1.11)、(12.25±1.43)、(12.16±1.19)mm],差异均有统计学意义(P<0.05)。结论改良腰椎后路椎间融合术能提高骨量减少的腰椎间盘突出症疗效,降低视觉疼痛模拟评分与腰椎Oswestry功能障碍指数评分,减少术中出血量,提高植骨融合率并降低椎间隙高度。Objective To investigate the efficacy of modified posterior lumbar interbody fusion in the treatment of osteopenic lumbar disc herniation and its impact on intraoperative blood loss and bone graft fusion rate.Methods One hundred and seven patients with lumbar intervertebral disc herniation admitted to the Department of Orthopedics of Affiliated Hospital of Xuzhou Medical University from November 2018 to November 2021 were prospectively selected and randomly divide into observation group(n=54)and control group(n=53).The observation group was treated with modified posterior lumbar interbody fusion,and the control group was treated with traditional posterior pedicle screw fixation.The efficacy,visual analogue scale(VAS)score results,lumbar Oswestry dysfunction index(ODI)at 1,3 and 6 months after operation,intraoperative blood loss,bone graft fusion rate at 3 and 6 months after operation and intervertebral space height at 1,3 and 6 months after operation were compared between the two groups.Results The effective rate of the observation group was 94.44%,which was better than 79.24%of the control group,the difference was statistically significant(P<0.05).The VAS score and ODI score of the observation group at 1,3,and 6 months after operation were(4.31±0.96),(2.22±0.47),(0.85±0.55)and(20.45±5.31),(11.12±3.63),(7.52)±2.32)points,all lower than the control group[(4.89±0.79),(2.97±0.38),(1.45±0.86)points and(26.53±5.73),(15.34±3.67),(10.75±2.65)points],the differences were statistically significant(P<0.05).The intraoperative blood loss in the observation group was(215.37±99.63)mL,which was less than the control group[(293.32±115.21)mL],the difference was statistically significant(P<0.05).The bone graft fusion rate in the observation group was 51.85%and 79.63%at 3 and 6 months after operation,which were higher than those in the control group(45.28%,69.81%),and the difference was statistically significant(P<0.05).The height of the intervertebral space in the observation group were(11.81±1.26),(10.92±0.96),(9.

关 键 词：腰椎间盘突出 改良PLIF 骨量减少 疗效 植骨融合率 

分 类 号：R687.3[医药卫生—骨科学]