小关节间隙植骨用于腰椎多节段融合术

目的：探讨小关节间隙植骨结合全椎板切除减压椎弓根螺钉内固定治疗腰椎管狭窄症的疗效。方法：88例腰椎管狭窄症患者，均行全椎板切除减压椎弓根螺钉内固定。其中横突间植骨组（A组）52例同时采用异体骨横突间植骨的方法，小关节间隙植骨组（B组）36例同时采用小关节间隙植骨。术后随访2周～5年，平均1年2个月。根据Oswestry评分标准，比较两组疗效结果，并观察术后1年的X线、CT，比较两组植骨愈合情况。结果：两组术后2周及3个月评分与术前评分有统计学差异（P〈0．001），B组得到较高评分。术后1年时两组评分与术前差异有显著性意义（P〈0．05），X线与CT显示植骨愈合情况相差不明显。结论：多节段腰椎管狭窄症小关节间隙植骨术与横突间植骨术相比，出血少，术后近期腰腿痛解除效果好，远期效果相当。

Bone grafting of intro-facet joint in the multisegmented lumbar fusion

Objective:To investigate the outcome of operation of laminectomy for decompression and pedicle screw fixation combined with bone grafting of intro-facet joint in treatment of lumbar spinal stenosis.Methods:Eighty-eight patients of lumbar spinal stenosis underwent operation of laminectomy for decompression and pedicle screw fixation.Among them,fifty-two patients also received allograft bone grafting of intertransverse process and the other 36 patients underwent bone grafting of intro-facet joint.After operation,all patients were followed-up from 2 weeks to 5 years with an average time of 14 months.Based on Oswestry Score,the outcome of the two groups was compared.The grafting bone healing between two groups was compared by observing X-ray film and CT taken one year after operation.Results:According to Oswestry Score,there was statistical difference between both groups at 2 weeks and 3 months after operation and before operation(P<0.001),and the intro-facet joint group got higher score than the other group.But there was significant difference between both groups at one year after operation and before operation(P<0.05).X-ray film and CT showed that there was no obvious difference in bone healing between two groups.Conclusion:As compared with the allograft bone grafting of intertransverse process,the bone grafting of intro-facet joint has less blood loss and less leg pain in a short term postoperatively.The long-term outcome are similar.