摘要
[目的]探讨采用双后外侧融合结合经后路的单点椎体间融合的三点稳定式脊柱融合术的临床应用效果。[方法]自1998年8月～2006年8月应用三点稳定式脊柱融合术治疗退行性腰椎间盘病变41例,其中男13例,女28例;平均年龄58岁,其中腰椎滑脱27例,腰椎退行性不稳并椎管狭窄14例。手术前后对患者的症状进行评估,并对X线平片进行测量,平均随访时间为19.1(12～66)个月。[结果]41例患者使用三点稳定式脊柱融合术,手术前的临床症状优2.4%(1/41)、良19.5%(8/41)、一般21.9%(9/41)、差56.1%(23/41)、良67.7%(21/31)。手术后的临床症状为优68.3%(28/41)、良29.2%(12/41)、中2.4%(1/41)、差0.0%(0/41)。X线平片测量椎间隙前部高度,术前(8.05±2.35)mm,术后(11.44±3.38)mm(P<0.05),椎间隙后部高度,术前(6.13±1.45)mm,术后(8.66±2.10)mm(P<0.01)。椎体滑脱的距离,术前(8.68±2.33)mm,术后(1.92±2.37)mm(P<0.05)。[结论]采用三点稳定式脊柱融合术治疗退行性腰椎间盘病变具有符合脊柱的生理负重特点,只用一个后路切口同时完成前后路融合,植骨量小、手术损伤较小、临床疗效满意。
[Objective]To explore the clinic results of bi-posterolateral fusion combined with coralline hydroxyapatite interbody fusion,a three point stable spine fusion technique in the treatment of degenerative vertebra disc disorder.[Method]Bi-posterolateral fusion combined with posterior interbody fusion were performed to treat 41 cases of degenerative vertebra disc disorder from August 1998 to August 2006.The patients included 18 men and 23 women;their average age was 48 years.The slippage and grade of spondylolisthesis before and after spine fusion were investigated.The severity and slippage of radiographic measurements were also recorded,along with the average follow up of 19.1 month（range 12-48 months）.The three point spine fusion applied autologous bone chips for bi-posterolateral fusion and one cubic block of coralline hydroxyapatite for anterior inter body fusion which achieved by PLIF technique.[Result]In the 41 patients who had underwent three point spine fusion surgery,only 1/41 patients experienced nerve root pain after surgery,and in most cases clinical symptoms were improved greatly.In 21/41 patients who had severe lower back pain completely disappeared after surgery,and in 9/41 cases these symptoms were minimal.The clinical evaluation according to the symptoms before the operation was excellent 2.4%（1/41）,good 19.5%（8/41）,fair 21.9%（9/41）,bad 56.1%（23/41）;after operation excellent 68.3%（28/41）,good 29.2%（12/41）,fair 2.4%（1/41）,bad 0.0%（0/41）.A radiographic measurements showed the anterior disc height was 8.05±2.35mm before operation and 11.44±3.38mm after operation（P 〈 0.05）,posterior disc height was 6.13±1.45mm before operation and 8.66±2.10mm after operation（P 〈 0.05）.The vertebra body slippage was 8.68±2.33 before operation and 1.92±2.37mm after operation（P 〈 0.01）.[Conclusion]Three point stable spine fusion meets the spine biomechanical load sharing and one incision to perform bi-posterolateral fusion and posterior lumbar interbody fusion in t
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2008年第19期1462-1465,共4页
Orthopedic Journal of China
关键词
三点稳定
腰椎间盘退行性变
脊柱融合
three point stable fusion
degenerative vertebra dis disordor
spinal fusion
