关节突自体骨移植后路腰椎间盘植骨融合固定术的临床分析

目的探讨关节突自体骨移植后路腰椎间盘植骨融合固定术治疗椎间盘退变的远期疗效。方法自2001年10月至2007年10月本组收治腰椎退变病人50例(平均53.2岁),用这一方法进行椎间融合,平均随访3年。用日本矫形协会标准(JOA)评分:痊愈率、并发症和X线片的结果进行综合的评定。结果关节突自体骨移植后路腰椎间盘植骨融合固定术,椎间融合率(92.0%),临床效果(JOA评定治愈率78.3%),在治疗椎间盘退变、椎体滑脱锥体骨折取得了良好的效果,术后有3个病人出现了并发症。结论关节突自体骨移植后路腰椎间盘植骨融合固定术治疗椎间盘退变疾病手术疗效满意,显著提高融合率,预防神经根管狭窄、神经卡压的发生,减少术后断钉和椎体滑脱复发等问题。

Long - term results of posterior lumbar interbody fusion using local facet joint autograft and pedicle screw fixation

Objective To investigate the late results of patients treated with PLIF using adjacent facet joint autograft and pedicle screw internal fixation.Methods Fifty patients(average,53.2 years) treated at our institution with PLIF by total facetectomy were followed for an average period of 3 years.The changes in the Japanese Orthopedic Association score(JOA),the recovery rate,complications,and radiographic findings were evaluated.Results Good radiographic fusion(92.0%) and clinical results(postoperative recovery rate of 78.3% in the Japanese Orthopedic Association score) were achieved by PLIF using local facet joint autograft and pedicle screw fixation in treating patients with debilitating lumbar degenerative disease.The complications related to the operative procedure occurred in three patients of delayed union.Conclusion PLIF using pedicle screw fixation and local autogenous bones obtained from facet excision may be justified as a treatment opinion.Which can increase the rate of fusion and decrease the complications such as broken screw,lateral spinal canal stenosis and spondylolisthesis recurrency postoperatively.