摘要
目的探讨椎间植骨融合的临床疗效及影响融合的相关解剖因素。方法分别是L3/4,L4/5,L5/S1间隙行椎间植骨融合术患者65例72椎间,椎间植入物为融合器或是自体髂骨块,所有患者卧床2周后带硬质腰部支具离床活动,卧床时则不需佩戴支具,两个月后去除支具,进行正常日常活动。术后1年通过CT检查植骨界面有无骨小梁桥接,有则已达到骨性融合。根据Nakal标准评分,将分值用Excell软件描点得散点图,根据每3个相邻连续散点的均值画出均线图,于均线变化明显处相对应的腰骶角处分组,比较各组临床效果及融合效果,并比较不同椎间隙的融合效果和同一椎间隙不同植入物的融合效果。结果当腰骶角大于45°时,不融合比例明显增高。L4/5,L5/S1间隙两组融合比例P<0.05,有显著差异。而同一椎间隙不同植入物则融合效果无显著性差异。结论腰骶角及椎间隙形态是影响椎间融合效果的因素,对于腰骶角超过45°的患者,术中应增加后外侧植骨,延长卧床时间或佩带硬质腰部支具时间。
Objective To research the clinical effects of posterior lumbar interbody fusion and correlative anatomy.Methods 65 cases（72 segments）underwent interbody fusion with single bone graft or cage.All patients exercise got out of bed taken the waist orthosis postoperation for 2 week.Checked up trabeculae at the bone interface by CT after operation 1 year.It indicated interbody fusion if found trabeculae.Based on Nakal standard,drawn up line graph and found out where variation sharp through software and compared the clinical effects.Results When the lumbosacral angle was greater than 45°,the rate of no fusion increased obviously.The fusion rate of L4/5 group had significant differences as rate of L5/S1 group（P0.05）.But in the same interbody,the fusion rate of fusion with single bone graft or cage had no significant difference.Conclusions The lumbosacral angle and intervertenral space have influence on interbody fusion effect.When the lumbosacral angle passes 45°,the posterolateral fusion should be added in interoperation and lengthen time lying in bed and wear supported braces after the operation.
出处
《齐齐哈尔医学院学报》
2010年第19期3032-3034,共3页
Journal of Qiqihar Medical University
关键词
腰椎
椎间融合
腰骶角
椎间形态
Lumbar Interbody fusion Lumbosacral angle Intervertenral space
