| 后路腰椎椎体间融合术联合不同椎间融合方式治疗单节段腰椎滑脱伴椎管狭窄症疗效比较 |
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| 引用本文： | 朱坤,许刚,叶雨辰,张知理,吴楠,赵睿.后路腰椎椎体间融合术联合不同椎间融合方式治疗单节段腰椎滑脱伴椎管狭窄症疗效比较[J].蚌埠医学院学报,2021,46(9):1192-1197. |
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| 作者姓名： | 朱坤 许刚 叶雨辰 张知理 吴楠 赵睿 |
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| 作者单位： | 1.蚌埠医学院第一附属医院 骨科, 安徽 蚌埠 2330042.蚌埠医学院 全科医学系, 安徽 蚌埠 233030 |
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| 基金项目： | 蚌埠医学院校自然科学基金重点项目BYKY2019057ZD安徽省卫生健康委科研项目AHWJ2021a009 |
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| 摘 要： | 目的探讨后路腰椎椎体间融合术(PLIF)联合不同椎间融合术治疗单节段腰椎滑脱症(LS)合并腰椎管狭窄症(LSS)的疗效。方法回顾性分析60例单节段LS合并LSS，将其分为观察组(钽金属cage+自体骨)31例和对照组(自体骨)29例。记录手术时间、术中出血量、术后引流、术后卧床休息时间。观察视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、腰椎滑脱程度、椎间隙后缘高度、腰椎前凸角度。结果2组椎间隙后缘高度术前、术后即刻比较差异无统计学意义(P>0.05)，术后3、12个月差异均有统计学意义(P < 0.01)。2组腰椎前凸角度术前、术后即刻差异均无统计学意义(P>0.05)，术后3、12个月比较差异均有统计学意义(P < 0.01)。2组术后即刻、术后3个月、术后12个月腰椎滑脱程度、椎间隙后缘高度、腰椎前凸角度均明显较术前改善(P < 0.05)。2组术后腰部VAS评分术前、术后即刻差异均无统计学意义(P>0.05)，术后3、12个月差异有统计学意义(P < 0.01)。2组病人术前、术后即刻、术后3个月及12个月腿部VAS评分和ODI差异均无统计学意义(P>0.05)。2组术后即刻、术后3个月、术后12个月腰部VAS评分、腿部VAS评分、ODI均优于术前(P < 0.05)。结论PLIF联合钽金属cage+自体骨移植组维持腰椎前凸角度、腰椎后缘高度，远期腰部疼痛缓解效果优于单纯自体骨移植组。
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| 关 键 词： | 腰椎滑脱 腰椎管狭窄 后路腰椎椎体间融合术 椎间融合 |
| 收稿时间： | 2021-05-30 |
Efficacy comparison of the posterior lumbar intervertebral fusion combined with different intervertebral fusion methods in the treatment of single-level lumbar spondylolisthesis complicated with spinal stenosis |
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| ZHU Kun,XU Gang,YE Yu-cheng,ZHANG Zhi-li,WU Nan,ZHAO Rui.Efficacy comparison of the posterior lumbar intervertebral fusion combined with different intervertebral fusion methods in the treatment of single-level lumbar spondylolisthesis complicated with spinal stenosis[J].Journal of Bengbu Medical College,2021,46(9):1192-1197. |
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| Authors: | ZHU Kun XU Gang YE Yu-cheng ZHANG Zhi-li WU Nan ZHAO Rui |
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| Affiliation: | 1.Department of Spinal Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 2330042.Department of General Medicine, Bengbu Medical College, Bengbu Anhui 233030, China |
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| Abstract: | ObjectiveTo investigate the clinical efficacy of posterior lumbar interbody fusion(PLIF) combined with different intervertebral fusion in the treatment of single-segment lumbar spondylolisthesis(LS) complicated with lumbar spinal stenosis(LSS).MethodsThe clinical data of 60 patients with LS complicated with LSS were retrospectively analyzed, and the patients were divided into the observation group(31 cases treated with tantalum cage combined with autograft bone) and control group(29 cases treated with autograft bone).The operation time, intraoperative blood loss, postoperative drainage and postoperative duration for bed rest in two groups were recorded.The visual analogue score(VAS), Oswestry dysfunction index(ODI), degree of spondylolisthesis, height of posterior margin of lumbar space and angle of lumbar lordosis in two groups were recorded throughout the treatment process.ResultsThere was no statistical significance in the height of posterior margin of intervertebral space between two groups before and immediately after surgery(P>0.05), but the differences of which between two groups after 3 and 12 months were statistically significant(P < 0.01).There was no statistical significance in the lumbar lordosis angle between two groups before and immediately after surgery(P>0.05), but the differences of which between two groups after 3 and 12 months were statistically significant(P < 0.01).The degree of lumbar spondylolisthesis, posterior margin height of intervertebral space and lumbar lordosis angle in two groups were significantly improved immediately after operation, 3 months after operation and 12 months after operation(P < 0.01).There was no statistical significance in the waist VAS score in two groups between postoperation, and before and immediately after surgery(P>0.05), but the differences of which in two groups between after 3 and 12 months were statistically significant(P < 0.01).There was no statistical significannce in the leg VAS score in two groups among before operation, immediately after surgery and after 3 and 12 months of operation(P>0.05).There was no statistical significance in the ODI in two groups among before operation, immediately after operation and after 3 and 12 months of operation(P>0.05).The waist VAS score, leg VAS score and ODI score in two groups immediately after surgery, after 3 months and 12 months of surgery were significantly better than those before operation(P < 0.01).ConclusionsThe PLIF combined with tantalum cage and autologous bone transplantation can maintain the lumbar lordosis angle and lumbar posterior margin height, and the long-term relief effects of lumbar pain of which is better than that of autologous bone transplantation alone. |
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