摘要
目的 :报道应用椎间融合器经后路减压椎间融合术 (PosteriorLumbarInterbodyFusion ,PLIF)治疗腰椎管狭窄症的临床效果 ,并对该术进行生物力学评价。方法 :采用后路扩大减压 ,单椎间盘摘除 ,椎间融合器植入 ,治疗严重腰椎管狭窄症 37例。实验研究中 ,取 6具新鲜尸体标本的L2 ～S1 节段制作脊柱功能单位 (FunctionalSpinalUnit,FSU)进行生物力学稳定性测试。结果 :术后对其中 33例患者进行平均 1年的随访 ,优良率 90 .8% ,X线评价椎体间骨融合率达 94.8% ,无严重并发症出现 ,生物力学结果表明 ,全椎板扩大减压导致椎节失稳 ,椎间融合器或椎弓根钉的使用可恢复节段稳定性。结论 :临床实践和生物力学实验均表明 ,椎间融合器在严重椎管狭窄症手术治疗中的应用是一种安全有效的方法 ,具有重建脊柱稳定性 ,恢复椎间隙和神经根管高度和增加椎间融合率等优势。
Objective:To investigate clinical results of posterior interbody fusion with cages for surgical treatment of lumbar stenosis and evaluate the biomechanical properties.Methods:Posterior wide decompression and interbody fusion with cages were preformed in thirty seven cases with severe lumbar stenosis.Biomechanical stability were studied in human cadaveric functional spinal unites(FSUs)by posterior wide decompression and installation of interbody cages or pedicle screw system.Results:Thirty three cases were followed up for 12 months postoperative.The excellent and good rates were 90.8%,solid fusion rate was 94.8% in 33 cases without severe complications.Experiment results showed that stability of the FSUs with posterior wide decompression decreased significantly( P <0.01)and stability obtained again by installation of interbody cages.Conclusions:The interbody fusion cage implant method has been found to be an effective and safe procedure for the treatment of lumbar stenosis,especially in severe cases.The implant reconstructs biomechanical stability for unstable lumbar spine,restores disc and foramen height,provides a high fusion rate for lumbar spine.
出处
《中国矫形外科杂志》
CAS
CSCD
2002年第7期688-690,共3页
Orthopedic Journal of China
