摘要
背景：骨质疏松的发病率高、并发症多,但其对后路腰椎椎体间融合术后骨融合的相关影响仍缺乏系统认识。目的：研究骨质疏松对后路腰椎椎体间融合（posterior lumbar interbody fusion,PLIF）术后骨融合的影响。方法：2010年1月至2014年6月,62例腰椎管狭窄合并腰椎失稳症患者行PLIF治疗。根据患者术前腰椎QCT值分为两组：骨质疏松组,28例;正常骨量组,34例。采用JOA评分、Nakai评分进行疗效评估,并用美国食品药品管理局推荐的方法判定植骨融合情况。结果：62例患者随访时间6~45个月,平均14个月。末次随访时组间的骨融合率、融合时间、JOA评分、Nakai评分结果比较,差异均有统计学意义（P〈0.05）。组内末次随访的JOA评分与各自术前值比较,均显著增加（P〈0.05）。结论：PLIF是治疗腰椎管狭窄合并腰椎失稳症的可靠方法,但骨质疏松可能通过加速移植骨吸收、抑制新骨形成、诱发内植物失稳等,导致骨融合率和临床疗效降低、融合时间延长,甚至融合失败。
Background： The osteoporosis is characterized by high morbidity and so many complications. But we cannot understand well the influence of osteoporosis on bone fusion after posterior lumbar interbody fusion （PLIF） now. Objective：To investigate the influence of osteoporosis on bone fusion after PLIF. Methods：A total of 62 patients with lumbar canal stenosis combined with lumbar instability were treated by PLIF from Janu-ary 2010 to June 2014 and enrolled in this study. They were divided into 2 groups according to preoperative bone mineral den-sity：osteoporosis group （n=28） and normal bone mass group （n=34）. The JOA score and Nakai score were used to evaluate cu-rative effects. The method recommended by the U.S. Food and Drug Administration was used to estimate the final fusion. Results：At the last follow-up, there were significant differences in the fusion rate, fusion time, JOA score and Nakai assess-ment between two groups （P〈0.05）. Compared with preoperative JOA scores, the final JOA score was significantly in-creased in each group （P〈0.05）. Conclusions：The mean duration of follow-up was 14 months （range, 6-45 months） in all patients. PLIF is a reliable method for the treatment of lumbar canal stenosis combined with lumbar instability syndrome. Osteoporosis may reduce the fusion rate and clinical outcome, prolong the fusion time and even lead to fusion failure by accelerating graft-bone absorption, re-straining the formation of new bone, and inducing the implant instability.
出处
《中国骨与关节外科》
2015年第6期482-485,共4页
Chinese Journal of Bone and Joint Surgery
基金
广西卫生厅科研课题(项目编号:Z2014119
Z2013190)
关键词
骨质疏松
脊柱融合术
腰椎
Osteoporosis
Spinal Fusion
Lumbar Vertebrae
