摘要
【目的】探讨后路单纯应用碳素纤维cage治疗退行性下腰椎不稳的疗效。【方法】回顾分析经双侧椎板开窗,单纯碳素纤维cage椎间融合治疗52例退行性下腰椎不稳的疗效。【结果】失访3例,49例随访8～25个月,平均19个月。术中硬脊膜损伤1例,予以修补,未出现脑脊液漏及神经损伤症状;再手术2例,术后一周cage脱出1例,另1例为术后3个月症状未缓解,均再次手术效果理想。JOA评分术前（10.5±1.6）分,术后1个月及末次随访分别为（22.8±2.2）分、（23.1±2.6）分,与术前比较均有差异（P〈0.01）。椎间隙高度手术前8.07±0.75 mm,术后一月及末次随访分别为12.50±1.81 mm,11.88±1.92 mm,与术前比较均有差异（P〈0.01）;RIS优良率85.74%,一年以上随访骨融合率为100%。【结论】经椎板开窗联合单纯碳素纤维cage椎间融合,对退行性下腰椎不稳是一种安全有效的手术方法。
[Objective]To investigate the clinical outcome of posterior stand-alone CFRP（carbon fibre reinforced polymer） Cage used in degenerative low lumbar instability. [Methods] Fifty two cases of degenerative low lumbar instability undergoing vertebral lamina fenestration combined with interbody fusion with stand-alone CFRP cage were retrospectively studied. Preoperative, 1-month postoperative and latest follow-up spinal functions were evaluated and graded by JOA score and RIS（the rate of improved JOA score）. The height of the intervertebral space and fusion status were measured as well. [Results]Three cases lost follow up, and 49 cases were followed up for 8 to 25 months （average 19 months）. Dural tear happened in one case, and dural sac was sutured. Neither cerebrospinal fluid leaking nor neurological injury was found. Reoperation happened in 2 cases including one case with cage escape in 1 week after surgery and another case with unrelieved neural symptom in 3 months after operation. Preoperative, 1-month postoperative and latest follow-up JOA scores were 10.5±1.6,22.8±2.2 and 23.1±2.6 respectively （ P 〈0.01）,while the height of intervertebral space were 8.07 ± 0.75mm, 12.50 ± 1.81mm and 11.88±1.92ram respectively（ P 〈0.01）. The excellent and good RIS was 85. 74% and the fusion rate of the cases followed up for over a year was 100%. [Conclusion] Vertebral lamina fenestration combined with interbody fusion with stand-alone CFRP cage is a safe and effective method in the treatment of degenerative low lumbar instability.
出处
《医学临床研究》
CAS
2007年第12期2065-2068,共4页
Journal of Clinical Research
关键词
腰椎
关节不稳定性
lumbar vertebrae
joint instability
