单侧与双侧椎弓根螺钉加椎间植骨融合治疗退行性腰椎不稳效果比较VIP免费

第20卷第6期2010年11月江苏大学学报(医学版)JournalofJiangsuUniversity(MedicineEdition)Vo1．20No．6NOV．2010单侧与双侧椎弓根螺钉加椎间植骨融合治疗退行性腰椎不稳效果比较贡小强，张亚俊，黄永辉(1．金坛市中医医院骨科，江苏金坛213200；2．江苏大学附属医院骨科，江苏镇江212001)[摘要]目的：观察减压后采用单侧椎弓根螺钉加椎间植骨融合术和双侧椎弓根螺钉加椎间植骨融合术治疗退行性腰椎不稳症的疗效。方法：3l例退行性腰椎不稳症患者，其中14例减压后采用单侧椎弓根螺钉内固定加椎间植骨融合(A组)，17例减压后采用双侧椎弓根螺钉内固定加椎间植骨融合(B组)。手术前以及末次随访时按日本矫形外科学会(JOA)腰腿痛疗效标准(29分法)进行评价，计算改善率和优良率，并随访观察植骨融合情况。结果：术中出血A组平均150ml，B组平均280mt；手术时间A组平均100min，B组平均170min。两组手术时间及出血量比较差异均有统计学意义(P<0．05)。术前JOA评分两组比较差异无统计学意义(P>0．05)，随访14～37个月(平均21个月)，末次随访时同组JOA评分与术前比较差异有统计学意义(P<0．01)，两组间比较无统计学差异(P>0．05)。两组间JOA评分改善率、优良率以及植骨融合率均无显著性差异(P>0．05)。结论：减压后采用单侧与双侧椎弓根螺钉加椎问植骨融合术都能有效治疗退行性腰椎不稳症。与后者比较，前者手术方法简单，是治疗退行性腰椎不稳可供选择的较好方法。[关键词]腰椎不稳症；椎弓根螺钉；椎问植骨融合；单侧固定[中图分类号]R681．5[文献标志码]A[文章编号]1671—7783(2010)06—0531一o4ComparativestudyofunilateralandlateralpediclescrewfixationwithintervertebralbodyfusionafterdecompressionintreatingdegenerativelumbarinstabilityGONGXiao—qiang，ZHANGYa-jun，HUANGYong—hui(1．DepartmentofOrthopaedics，JintanTraditionalChineseMedicalHospital，JintanJiangsu213200；2．DepartmentofOrthopaedics，theAffili-atedHospitalofJiangsuUniversity，ZhenjiangJiangsu212001，China)[Abstract]0bjective：Toinvestigatethesurgicaloutcomeofunilateralandlateralpediclescrewfixationwithintervertebralbodyfusionafterdecompressionfordegenerativelumbarinstability．Methods：Thirty-onecasesofdegenerativelumbarinstabilitywerereviewedretrospectively．Fourteencasesunderwentaunilateralpediclescrewfixationwithintervertebralbodyfusionafterdecompression(groupA)，while17casesexpefi—encedunilateralpediclescrewplacement(groupB)．JOA29scoresystemwereusedtoevaluatetheneuro—logicalfunctionandtheexcellentrateandimproverate，andfusionstatuswerereviewedretrospectivelyaswel1．Results：Theaveragebloodlosswas150mlingroupA，280mlingroupB．Theaverageoperationtimewas100miningroupA，and170miningroupB．Thebloodlossandoperationtimebetweentwogroupsshowedremarkabledifference(P<0．05)．PreoperativeJOAscorebetweentwogroupsshowednosig—nificantdifference(P>0．05)．Afteranaverageof21monthsfollow—up(range，14—37months)，JOAscorebetweentwogroupsatfinalfollow·upshowednosignificantdifference(P>0．05)．However，therewassig—nificantdifferencecomparedwithpreoperativecounterparts(P<0．01)．Theexcellentrate，improverateandbonyunionratebetweentwogroupsshowednosignificantdifference(P>0．05)．Conclusion：Unilat—eralandlatera1pediclescrewfixationwithintervertebralbodyfusionafterdecompressionarebothoptional[作者简介]贡小强(1964一)，男，江苏金坛人，主治医师，主要从事骨外科临床研究。532江苏大学学报(医学版)第2O卷fordegenerativelumbarinstability．Comparedtothelatter，unilateralpedicleserewfixationappearsrelative、lymoreconvenientwiththesameeffect．[Keywords]lumbarinstabilitysyndrome；pediclescrew；intervertebralbodyfusion；unilateralfixation腰痛是困扰人类的常见病和...