不同材料融合器对腰椎管狭窄症影像学及组织创伤的影响  

Effects of different fusion cages on imaging and tissue trauma of lumbar spinal stenosis

作　　者：王建华[1] 吴迪[1] 孙贺[1] 张义龙[1] 信丽丽[1] 张仁赞 WANG Jian-hua;WU Di;SUN He;ZHANG Yi-long;XIN Li-li;ZHANG Ren-zan(Spinal Surgery Department,Affiliated Hospital of Chengde Medical College,Chengde,Hebei 067000,China)

机构地区：[1]承德医学院附属医院脊柱外科,河北承德067000

出　　处：《颈腰痛杂志》2023年第6期999-1003,共5页The Journal of Cervicodynia and Lumbodynia

基　　金：承德市科技支撑计划项目(编号:201606A049)。

摘　　要：目的探讨不同材料融合器对腰椎管狭窄症影像学及组织创伤的影响。方法收集承德医学院附属医院收治的76例腰椎管狭窄症患者临床资料进行回顾性分析,根据椎间融合器种类分为3D打印钛合金组(n=38)和聚醚醚酮(polyether ether ketone,PEEK)组(n=38),分别采取3D打印钛合金椎间融合器、PEEK椎间融合器进行椎间融合。统计两组治疗效果。结果术后12个月,钛合金组手术优良率89.74%与PEEK组87.18%比较,无显著差异(P>0.05);两组手术时间、术中失血量、首次下床活动时间比较,无显著差异(P>0.05);术后3个月、6个月,两组JOA评分、VAS评分比较,无显著差异(P>0.05);术后24 h两组血清CRP、CK水平均显著高于术前(P<0.05);2组融合器下沉率等并发症发生率、植骨融合率比较,无显著差异(P>0.05)。结论3D打印钛合金融合器与PEEK融合器相比,虽可降低腰椎管狭窄症融合器下沉率,提高同期椎间融合率,但二者并无显著的统计学差异。Objective To investigate the effects of different fusion cages on the imaging and tissue trauma of lumbar spinal stenosis.Methods The clinical data of 76 patients with lumbar spinal stenosis admitted to the Affiliated Hospital of Chengde Medical College from January 2017 to December 2019 were collected and analyzed retrospectively.According to the types of interbody fusion cage,they were divided into titanium alloy group(n=38)and polyether ether ketone(PEEK)group(n=38).The titanium alloy and PEEK were printed by 3D printing technology respectively.The clinical efficacy,operation time,intraoperative blood loss,first ambulation time,complications and bone graft fusion rate of the two groups were counted,and the quantitative indexes of lumbar function,pain degree and trauma before and after operation were compared.Results(1)12 months after operation,the excellent and good rate of titanium alloy group was 89.74%,which had no significant difference compared with 87.18%in PEEK group(P>0.05).(2)There was no significant difference in operation time,intraoperative blood loss and first ambulation time between the two groups(P>0.05).(3)The JOA and VAS scores of the two groups were significantly improved 3 and 6 months after operation(P<0.05),and there was no significant difference between the two groups 3 and 6 months after operation(P>0.05).(4)24 hours after operation,the levels of serum CRP and CK in the two groups were higher than those before operation(P<0.05).(5)There was no significant difference in the subsidence rate of the cage between the titanium alloy group and the PEEK group(P>0.05).(6)There was no significant difference in the bone graft fusion rate between the titanium alloy group and the PEEK group 6 and 12 months after operation(P>0.05).Conclusion Compared with PEEK fusion cage,3D printed titanium alloy fusion cage can reduce the sink rate of fusion cage in lumbar spinal stenosis and improve the interbody fusion rate in the same period,but there is no significant difference between them.

关 键 词：椎间融合 腰椎管狭窄症 聚醚醚酮融合器 3D打印钛合金融合器 

分 类 号：R681.57[医药卫生—骨科学]