自体骨腰椎椎间融合器在后路腰椎椎间融合术治疗退行性腰椎疾患的效果  

Effect of autogenous bone lumbar intervertebral fusion cage for posterior lumbar interbody fusion in the treatment of lumbar degenerative diseases

作　　者：张振山[1] 黄福立[1] 李健[2] 朱豪东 ZHANG Zhenshan;HUANG Fuli;LI Jian;ZHU Haodong(Department of Spine and Orthopedics,Zhongshan Hospital of Traditional Chinese Medicine,Guangdong,Zhongshan 528400,China;Department of Spine,the Fifth Affiliated Hospital of Guangzhou Medical University,Guangdong,Guangzhou 510700,China)

机构地区：[1]广东省中山市中医院脊柱骨科,广东中山528400 [2]广州医科大学附属第五医院脊柱科,广东广州510700

出　　处：《中国医药科学》2022年第6期18-22,共5页China Medicine And Pharmacy

基　　金：广东省医学科研基金项目(A2020632);广东省中山市第一批社会公益与基础研究项目(2020B1059)。

摘　　要：目的研究自体骨腰椎椎间融合器(自体骨cage)在后路腰椎椎间融合术治疗退行性腰椎疾患的临床效果。方法选取2019年4月至2020年4月中山市中医院、广州医科大学附属第五医院收治的退行性腰椎疾患行后路椎间融合内固定手术患者80例,采用随机数字表法将其分为观察组(n=38)和对照组(n=42),观察组采用自体骨腰椎椎间融合器、对照组采用人工融合器;观察两组融合器联合内固定术治疗退行性腰椎疾患的术中出血量、手术时间、术中并发症等各项临床指标、植骨融合率、相对椎间隙高度等影像学指标及腰腿痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)等临床疗效评分,收集相关数据进行对比分析。结果两组术中出血量、手术时间、术中并发症比较,差异无统计学意义(P>0.05),两组术后3个月VAS评分与ODI评分低于术前,差异有统计学意义(P<0.05);术后3个月、6个月、1年时,两组VAS和ODI评分比较,差异无统计学意义(P>0.05);术后椎间隙高度较术前增加,差异有统计学意义(P<0.05),术后3个月、6个月、1年时两组椎间隙高度有丢失,差异均无统计学意义(P>0.05);术后1年,两组植骨融合率比较,差异无统计学意义(P>0.05)。结论自体骨腰椎椎间融合器结合椎弓根螺钉内固定具有生物力学稳定性,与人工椎间融合器结合椎弓根钉内固定均能有效治疗退行性腰椎疾患,融合率高。Objective To study the clinical efficacy of autologous bone lumbar intervertebral fusion cage(autologous bone cage)for posterior lumbar interbody fusion in the treatment of lumbar degenerative diseases.Methods A total of 80 patients with lumbar degenerative diseases undergoing posterior lumbar interbody fusion and internal fixation surgery admitted to Zhongshan Hospital of Traditional Chinese Medicine and the Fifth Affiliated Hospital of Guangzhou Medical University from April 2019 to April 2020 were selected and divided into two groups according to the random number table method.The obsevation group(n=38)received fusion procedure with autologous bone cage,while the control group(n=42)received fusion procedure with artificial interbody fusion cage.The intraoperative bleeding volume,operation duration,intraoperative complications and other clinical indexes,bone graft fusion rate,relative lumbar space height and other imaging indexes,as well as the Visual Analogue Scale(VAS)score for lumbocrural pain and Oswestry disability index(ODI)and other clinical efficacy scores of the two groups were observed in the treatment of lumbar degenerative diseases by the two kinds of fusion procedures combined with internal fixation,and the relevant data were collected for comparative analysis.Results There were no statistically significant differences between the two groups in intraoperative bleeding volume,operation duration,and intraop erative complications(P>0.05).The VAS scores and ODI scores in both groups at 3 months after surgery were lower than those before surgery,with statistically significant differences(P<0.05),while there were no s tatistically significant differences between the two groups in the VAS and ODI scores at 3 months,6 months,and 1 year after surgery(P>0.05).There was an increase of lumbar space height in both groups after surgery,with statistically significantly different from the lumbar space height in both groups before surgery(P<0.05).In addition,there was a loss of lumbar space height in both groups at

关 键 词：自体骨 融合器 生物力学 椎弓根螺钉 

分 类 号：R687.3[医药卫生—骨科学]