摘要
目的探讨腰椎滑脱患者行腰后路减压复位椎间植骨融合内固定术后应用伊班膦酸钠对椎间融合效果的影响。方法选取腰椎滑脱患者63例,均行腰后路滑脱复位椎间植骨融合内固定术,依据术后药物应用不同分为试验组33例与对照组30例。试验组术后1周起每3个月应用3mg伊班膦酸钠120min缓慢静脉滴注,疗程24个月;对照组不应用伊班膦酸钠类药物。2组分别于术前及末次随访时进行腰痛症状Oswestry功能障碍指数(Oswestry Dability Index,ODI)评分、腰痛和下肢疼痛症状视觉模拟疼痛评分法(Visual Analogue Scale,VAS)评分,以及骨密度、X线和CT检查,比较2组临床症状评分、椎间高度、融合率、骨密度。结果末次随访时,2组腰痛症状ODI评分、腰痛症状VAS评分、下肢疼痛症状VAS评分均低于术前,试验组腰痛症状ODI评分、腰痛症状VAS评分低于对照组(P<0.05)。2组椎间隙高度小于术后,试验组椎间隙高度大于对照组,试验组椎间隙高度丢失小于对照组,融合率高于对照组(P<0.05)。试验组腰椎骨密度和左股骨粗隆间骨密度明显高于治疗前,试验组腰椎骨密度和左股骨粗隆间骨密度高于对照组(P<0.05)。结论腰后路滑脱复位椎间植骨融合术后应用伊班膦酸可促进椎间融合,改善腰痛症状。
Objective To investigate the effects of ibandronate on intervertebral fusion the lumbar spondylolisthesis patients underwent lumbar posterior decompression and interbody fusion and internal fixation.Methods Sixty-three cases of lumbar spondylolisthesis patients were underwent lumbar posterior interbody fusion and internal fixation.The patients were divided into experimental group and control group according to different postoperative drug use.The experimental group of 33 patients used 3 mg ibandronate for 120 minutes by slow intravenous a week after surgery,every 3 months for 24 months.The control group of 30 patients did not use the application of ibandronate drugs.The two groups were evaluated on the low back pain Oswestry Dability Index(ODI)score,lumbago leg pain symptoms Visual Analogue Scale(VAS)score,bone density,X-ray and CT examinations before and at the last follow-up and the clinical symptom score,intervertebral height,fusion rate and bone mineral density were compared between the two groups.Results At the end of the follow-up,pain ODI score and VAS score of two groups were significantly lower than those before operation,the experimental group was lower than the control group according to the ODI score and VAS score of the lumbago(P<0.05).The height of the intervertebral space of the 2 groups was smaller than that of the postoperative,the height of the intervertebral space of the experimental group was higher than that of the control group,loss of intervertebral height was less in experimental group,and the interbody fusion the rate of experimental group was higher than the control group(P<0.05).The bone mineral density of the lumbar spine and the bone mineral density of the left femur were higher in the experimental group than in the control group,the bone mineral density of the lumbar spine and the bone mineral density of the left femur were higher in the experimental group than those in the control group(P<0.05).Conclusion Application of ibandronate can promote interbody fusion,improve the symptoms of low back pain after the posterior lumbar decompression and reduction and interbody fusion.
出处
《河北医科大学学报》
CAS
2017年第11期1287-1291,共5页
Journal of Hebei Medical University
基金
衡水市科学技术研究与发展指导计划(2016014103Z)
