两种植骨融合内固定术治疗骨质疏松老年腰椎管狭窄症的效果  

Effect of two bone implants fusion and internal fixation in the treatment of osteoporotic elderly lumbar spinal stenosis

作　　者：贺靖澜[1] 林晓光 汪亮 赵艳春 张瑞英[2] 申娜[3] HE Jinglan;LIN Xiaoguang;WANG Liang;ZHAO Yanchun;ZHANG Ruiying;SHEN Na(Department of Orthopedics,Affiliated Hospital of Hebei University of Technology,Hebei Province,Handan056004,China;Department of Geriatrics,Affiliated Hospital of Hebei University of Technology,Hebei Province,Handan056004,China;Department of Science and Education,Affiliated Hospital of Hebei University of Technology,Hebei Province,Handan056004,China)

机构地区：[1]河北工程大学附属医院骨科,河北邯郸056004 [2]河北工程大学附属医院老年科,河北邯郸056004 [3]河北工程大学附属医院科教处,河北邯郸056004

出　　处：《中国医药导报》2023年第15期86-89,94,共5页China Medical Herald

基　　金：河北省科技厅重点研发项目基金资助项目(21377797D)。

摘　　要：目的观察使用单纯植骨与使用融合器的PLIF手术治疗骨质疏松老年退行性腰椎管狭窄症的效果。方法将2019年8月至2021年12月河北工程大学附属医院治疗的75例骨质疏松老年退行性腰椎管狭窄症患者作为研究对象,采用随机数字表法,分为单纯植骨治疗组(38例)和椎间融合器治疗组(37例)。应用视觉模拟(VAS)评分和Oswestry功能障碍指数(ODI)评分量表分别于术前、术后6个月对两组评分并比较;比较术前、术后1个月及术后18个月减压节段椎间隙高度;两组住院天数、住院费用及术中减压节段椎间隙植骨量;两组术后3、18个月植骨融合情况。结果术后,两组ODI、VAS评分低于术前,差异有统计学意义(P<0.05)。两组术后ODI、VAS评分比较,差异无统计学意义(P>0.05)。整体分析发现,两组组间、交互作用比较,差异无统计学意义(P>0.05);不同时间比较,差异有统计学意义(P<0.05)。进一步两两比较,术后1个月两组减压节段椎间隙高度高于术前,术后18个月两组减压节段椎间隙高度低于术后1个月,差异有统计学意义(P<0.05)。两组住院天数比较,差异无统计学意义(P>0.05)。椎间融合器治疗组住院费用高于单纯植骨治疗组,减压节段椎间隙植骨量低于单纯植骨治疗组,差异有统计学意义(P<0.05)。术后3个月单纯植骨治疗组植骨融合例数多于椎间融合器治疗组,差异有统计学意义(P<0.05)。术后18个月两组植骨融合例数比较,差异无统计学意义(P>0.05)。结论经保守治疗无效的骨质疏松老年退行性腰椎管狭窄症患者,选择经腰椎后路椎管减压、单纯植骨融合、椎弓根螺钉内固定术可以达到经济有效的治疗目的。Objective To observe the effect of PLIF surgery with bone graft alone and fusion apparatus in the treatment of osteopolitic senile degenerative lumbar spinal stenosis.Methods A total of 75 elderly patients with osteoporosis and degenerative lumbar spinal stenosis treated in the Affiliated Hospital of Hebei University of Technology from August 2019 to December 2021 were selected as subjects.By random number table method,they were divided into bone graft treatment group(38 cases)and interbody fusion cage treatment group(37 cases).Visual analog scale(VAS)and Oswestry disability index(ODI)scale were used to score and compare the two groups before and six months after surgery.The height of decompression intervertebral space before surgery,1 month after surgery and 18 months after surgery,the length of hospitalization,hospitalization cost,and the amount of bone graft in the intervertebral space during decompression between the two groups,and the situation of bone graft fusion between the two groups 3 and 18 months after surgery were compared.Results After operation,ODI and VAS scores of the two groups were lower than those before operation,and the differences were statistically significant(P<0.05).There were no significant differences in postoperative ODI and VAS scores between the two groups(P>0.05).The overall analysis showed that there was no significant difference in the interaction between the two groups(P>0.05).The difference was statistically significant at different time points(P<0.05).Further pair-wise comparison showed that the decompression level vertebral space height of the two groups was higher than that before surgery a month after surgery,and the decompression level vertebral space height of the two groups was lower than that 1 month after surgery and 18 months after surgery,with statistical significance(P<0.05).There was no significant difference in the length of hospitalization between the two groups(P>0.05).The hospitalization cost of the interbody fusion apparatus treatment group was higher than tha

关 键 词：腰椎管狭窄 单纯植骨 内固定 老年 

分 类 号：R681.5[医药卫生—骨科学]