骨形态发生蛋白联合腰椎融合术对单节段腰椎管狭窄症患者术后融合器沉降及融合率的影响  

Effect of bone morphogenetic protein combined with lumbar fusion on postoperative cage settlement and fusion rate in patients with single-segment lumbar spinal stenosis

作　　者：刘芳宏[1] 韩志杰 尚振国 安小刚[1] 丁文义[1] 张海霞[1] LIU Fang-hong;HAN Zhi-jie;SHANG Zhen-guo;AN Xiao-gang;DING Wen-yi;ZHANG Hai-xia(Department of Orthopedics,Jizhong Energy Fengfeng Group General Hospital,Hebei,056000,China)

机构地区：[1]冀中能源峰峰集团总医院骨二科,河北邯郸056000

出　　处：《颈腰痛杂志》2023年第3期366-369,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：河北省2017年度医学科学研究重点课题计划(编号:20171516)。

摘　　要：目的研究骨形态发生蛋白联合腰椎融合术对单节段腰椎管狭窄症患者术后融合器沉降及融合率的影响。方法选取2016年11月~2018年11月本院收治的206例单节段腰椎管狭窄症患者,随机将患者分成观察组和对照组各103例。对照组患者行单节段后路经椎间孔腰椎管减压融合固定术(transforaminal lumbar interbody fusion,TLIF),观察组患者行骨形态发生蛋白联合单节段TLIF手术。对比两组患者手术情况、临床疗效、ODI指数、疼痛VAS评分、融合器沉降情况、融合率及安全性等指标。结果两组患者术中出血量、手术时间和住院时间等指标差异无统计学意义(P>0.05);治疗后,观察组患者优良率为87.38%,显著高于对照组的76.70%(P<0.05);两组患者术后1年和术后6个月的ODI指数和VAS评分明显低于术前,且两组患者术后1年的两项指标均明显低于术后6个月(P<0.05)。术后1年,观察组患者融合器沉降度明显低于对照组;观察组患者的椎间植骨融合率为100.0%,明显高于对照组的94.17%(P<0.05);随访期间,两组患者均出现融合器移位、感染、血肿、神经根性疼痛及钉棒断裂或松动等不良反应事件,但差异无统计学意义(P>0.05)。结论骨形态发生蛋白联合TLIF手术可有效增强临床疗效,改善患者疼痛程度,降低功能障碍,减少融合器沉降度,提高椎间融合器的融合率,安全有效。Objective To explore theeffect of bone morphogenetic protein combined with lumbar fusion on postoperative cage settlement and fusion rate in patients with single-segment lumbar spinal stenosis.Methods A total of 206 patients with single segmental lumbar spinal stenosis treated in our hospital from November 2016 to November 2018 were randomly divided into the observation group(n=103)and the control group(n=103).The control group was treated with transforaminal lumbar interbody fusion,and the observation group was treated with bone morphogenetic protein combined with transforaminal lumbar interbody fusion.The operation,clinicalefficacy,Oswestry disability index,visual analogue score,fusion cage settlement,fusion rate and safety were compared between the two groups.Results There was no significant difference in intraoperative blood loss,operation time and hospital stay between the two groups(P>0.05).After treatment,the excellent and good rate of the observation group was 87.38%,which was significantly higher than that of the control group(76.70%)(P<0.05).The Oswestry disability index and pain score in the two groups 1 year and 6 months after operation were significantly lower than those before operation,and the Oswestry disability index and pain score 1 year and 6 months after operation in the two groups were significantly lower than those 6 months after operation(P<0.05).One year after operation,the settlement of fusion cage in the observation group was significantly lower than that in the control group,while the fusion rate in the observation group was 100%,which was significantly higher than that in the control group(94.17%)(P<0.05).During the follow-up period,adverse reactions such as cage displacement,infection,hematoma,nerve root pain and nail rod fracture or loosening occurred in both groups,but there was no significant difference between the two groups(P>0.05).Conclusion Bone morphogenetic protein combined with lumbar fusion can effectively enhance the clinical efficacy,improve the pain degree,reduce the Osw

关 键 词：骨形态发生蛋白 经椎间孔腰椎椎间融合术 腰椎管狭窄症 融合器沉降 融合率 

分 类 号：R687.3[医药卫生—骨科学]