摘要
[目的]比较单侧椎弓根钉固定联合单枚Cage植骨融合术与双侧椎弓根钉固定并单枚椎间融合器融合术治疗腰椎退行性疾病的疗效差异。[方法]2008年1月～2011年12月行内固定结合椎间融合术治疗腰椎退变性疾病患者98例,其中男50例,女48例;年龄31～75(45.8±2.1)岁。根据椎弓根钉内固定的不同,将患者随机分成两组:单侧固定组40例,采用单侧椎弓根钉内固定联合单枚Cage植骨融合术治疗;双侧固定组58例,采用双侧椎弓根固定并单枚椎间融合器融合治疗。比较两种手术失血量、手术时间、住院天数、融合率及并发症情况,同时术前、术后均应用疼痛视觉模拟(visual analog scale,VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)评分来评估患者的恢复情况。[结果]单侧椎弓根钉联合单枚Cage植骨融合术组在手术时间、术中失血量和住院天数均优于双侧椎弓根固定并单枚椎间融合器融合(P<0.05)。两组患者并发症率和融合率的差异无统计学意义(P>0.05)。两组患者腰痛、腿痛VAS评分及ODI评分较术前均得到明显改善(P<0.05),但两组之间的差异并无统计学意义(P>0.05)。融合率方面:单侧组为92.50%(37/40例),双侧组为96.55%(56/58例)。[结论]在合理选择适应证的情况下,单侧椎弓根螺钉固定联合单枚Cage植骨融合术治疗腰椎退行性疾病与双侧椎弓根钉固定临床效果相同,且具有手术时间短、出血量少、住院时间短等优点,是一种安全可行的手术方法。
[Objective] To compare the clinical efficacy of internal fixation with unilateral versus bilateral transpedicle screws combined with intervertebral fusion in lumbar degenerative diseases. [ Methods] From January 2008 to December 2011, 98 patients with lumbar degenerative diseases were treated by internal fixation combined with intervertebral fusion. There were 50 males and 48 females with average age of 45. 8 years ranging from 31 to 75 years. These patients were randomly divided into two groups according to the internal fixation type. The unilateral fixation group underwent with transforaminal lumbar interbody fusion and the unilateral pedicle screw with one single cage placement; and the bilateral group used the unilateral pedicle screw com- bined with one single cage placement. Volume of blood loss, operative time, hospitals stays, fusion rate and complication rate were compared. Meantime, the VAS score and ODI score system were used to evaluate the preoperative and postoperative func- tion recovery. [ Results] The operative time, operative time and hospitals stays of the unilateral fixation group were better than those of patients of bilateral fixation group （P 〈 0. 05 ） . The differences of fusion rate and incidence rate of complication had no statistical significance （ P 〉 0. 05 ） . Two groups of VAS pain scores which consisted of back and leg and the ODI scores after operation had improved obviously than preoperative （P 〈 0. 05 ） , but the differences of them had no statistical significance （P 〉 0. 05） . Concerning the fusion rate, the unilateral fixation group was 92. 50% （37/40） and the the bilateral fixation group was 96. 55% （56/58） . [ Conclusion] Under the reasonable indication, the internal fixation with unilateral transpedicle screws combined with intervertebral fusion is as effective as with bilateral instruments in lumbar degenerative diseases, which is a safe and feasible surgical method. In addition, it has the advantages of short operative time, less blood loss and less hospitals stays.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2013年第7期651-657,共7页
Orthopedic Journal of China
关键词
腰椎退行性疾病
椎弓根钉
椎间融合器
单侧
双侧
lumbar degenerative disease, pedicle screw system, interbody fusion cage, unilateral, bilateral
