摘要
目的比较单侧椎弓根螺钉暨经皮对侧椎板关节与双侧椎弓根螺钉两种固定方法联合椎间融合器植骨治疗下腰椎病变的3年随访结果。方法手术治疗62例单节段下腰椎病变患者,其中30例行单侧椎弓根螺钉暨经皮对侧椎板关节突螺钉固定联合椎间融合器植骨术(A组),32例行双侧椎弓根螺钉固定联合椎间融合器植骨术(B组),比较两组患者手术创伤和临床疗效。结果两组手术切口长度、手术时间、术中出血量、术后引流量比较A组优于B组,差异均有统计学意义(P<0.05)。两组融合率比较差异无统计学意义(P>0.05)。腰痛VAS评分与JOA评分:术后各时点(术后1周和术后6、12、24、36个月)两组较术前明显改善(P<0.05),两组之间比较差异无统计学意义(P>0.05)。结论单侧椎弓根螺钉暨经皮对侧椎板关节与双侧椎弓根螺钉两种固定方法联合椎间融合器植骨术治疗下腰椎病变3年随访疗效均满意;单侧椎弓根螺钉联合对侧经皮椎板关节突螺钉固定具有操作简单、创伤小、稳定性好、融合率高和并发症少等优点,是部分下腰椎病变固定融合的较好选择。
Objective To compare the 3-year outcomes of patients undergoing the invasive transforaminal lumbar interbody fusion combined with unilateral lumbar pedicle screw and undergoing translamina facet screw fixation versus conventional posterior lumbar interbody fusion combined with bilateral pedicle screw fixation. Methods 62 cases with lower lumbar vertebrae diseases,who underwent surgery were successfully followed up for 3 years. 30 cases（ group A）underwent the invasive transforaminal lumbar interbody fusion combined with unilateral lumbar pedicle screw; of these patients,32 cases（ group B） underwent translamina facet screw fixation versus conventional posterior lumbar interbody fusion combined with bilateral pedicle screw fixation. The surgical trauma and clinical outcomes between 2groups were compared. Results There were significant differences between two groups regarding to the length of incision,operation time,intraoperative blood loss and postoperative draining（ P〈0. 05）,for the group A was better than group B. No implant failure was noted during the follow-up,there was not significant dfference for the bone fusion rate between two groups and JOA score and VAS score grade significantly improved from baseline at each time point（ a week postoperation and 6,12,34,36 months after surgery） in both groups（ P〈0. 05）,although there were no significant differences between the two groups（ P〉0. 05）. Conclusions These two approaches have similar clinical outcomes for single-level lumbar degenerative disorders with no instability. Unilatera J pedicle screw combined with contralateral translamiar facet screw fixation by pertcutaneous and interbody fusion provide simple procedure,little truama,forceful fixation,high fusion rate,and less complication,etc. Therefore,the surgical maneuver is good choice for partial low lumbar vertebra diseases.
出处
《临床骨科杂志》
2015年第3期257-260,共4页
Journal of Clinical Orthopaedics
基金
浙江省卫生厅科研资助项目(编号:2010KYB112)
