两种融合方法治疗腰椎失稳的疗效比较

目的对比两种融合方法治疗腰椎失稳的临床效果。方法回顾性分析2009年3月至2011年2月收治的腰椎失稳49例。分别采用c型植骨融合内固定（A组，25例）和椎间融合器融合内固定方法（B组，24例）治疗。比较两组手术时间、术中出血量、住院时间、材料费用、JOA评分及融合成功率。结果所有患者均获得随访，随访时间6—18个月，平均11个月。两组间手术时间、术中出血量、住院时间、JOA评分及融合成功率差异无统计学意义（P〉0．05），而在材料费用方面两组差异有统计学意义（P〈0．01）。结论在椎弓根螺钉系统固定的基础上，采用c型植骨融合治疗腰椎失稳在临床疗效、植骨融合率方面与椎间融合器融合疗效及融合率相近，但c型植骨融合内固定大大降低了患者的经济负担，更适合在临床中推广应用。

Comparative Study of Two Different Spinal Fusion in Treating Lumbar Instability

Objective To compare the clinical effects of two different spinal fusion in treatment of lumbar instability. Methods 49 patients with lumbar instability were admitted to our hospital from March 2009 to February 2011. Group A（25 cases） underwent pedicle screw fixation plus type C bone graft interbody fusion while group B （24 cases） underwent pedicle screw fixation plus cage interbody placement. Operation time, amount of bleeding, hospital stay, material fee, JOA scor and suc- cessful fusion rate of the two groups were compared. Results The meanpostoperative follow up time was 11 months （ranged ,6 ~ 18 months）. There was no significant difference in the operation time, amount of bleeding, hospital stay, JOA score and fu- sion rate between the two groups（P 〉 0.05 ）. There was significant difference in material fee between two groups （P 〈 O. 01 ）. Conclusion The pedicle screw fixation plus type C bone graft interbody fusion and plus cage interbody placement have the similar therapeutic effects for lumbar instability. But type C bone fusion and internal fixation greatly reduces the economic bur- den of the patients and is more suitable for clinical application.