中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (13): 2425-2428.doi: 10.3969/j.issn.1673-8225.2010.13.036

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

腰椎间孔入路腰椎体间植骨融合结合椎弓根螺钉置入内固定：能提高退行性病变腰椎的稳定性与植骨融合率吗？

朱建炜1，刘  璠1，张  烽1，董启榕2，侍  德1   

  1. 1南通大学附属医院骨科，江苏省南通市 226001；   2苏州大学附属第二医院骨科，江苏省苏州市  215004
  • 出版日期:2010-03-26 发布日期:2010-03-26
  • 作者简介:朱建炜☆，男，1973年生，江苏省南通市人，汉族， 2006年苏州大学毕业，博士，副教授，主要从事骨与关节损伤研究。 zhujianweint@126.com

Transforaminal lumbar interbody fusion based on pedical fixation: Can it increase lumbar stability and fusion rate?

Zhu Jian-wei1, Liu Fan1, Zhang Feng1, Dong Qi-rong2, Shi De1   

  1. 1 Department of Orthopaedics, Affiliated Hospital of Nantong University, Nantong  226001, Jiangsu Province, China; 2 Department of Orthopaedics, Second Affiliated Hospital of Soochow University, Suzhou  215004, Jiangsu Province, China
  • Online:2010-03-26 Published:2010-03-26
  • About author:Zhu Jian-wei☆, Doctor, Associate professor, Department of Orthopaedics, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China zhujianweint@126.com

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摘要：

背景：腰椎融合已广泛应用于治疗各种腰椎退行性疾病，然而传统的经后方或后外侧入路融合率较低，并发症较多，影响相邻脊柱节段的稳定性，破坏了脊柱的机械载荷分布。
目的：探讨经腰椎间孔入路行腰椎体间植骨融合结合椎弓根螺钉置入内固定治疗腰椎退行性疾病的临床效果。
方法：68例腰椎退行性疾病患者行腰椎间孔入路腰椎体间植骨融合结合短节段椎弓根螺钉置入内固定，其中峡部裂型腰椎滑脱24例、退变性腰椎滑脱16例、退变性腰椎管狭窄18例和退变性腰椎间盘疾病10例。
结果与结论：所有患者无神经损伤、椎间隙感染和脑脊液漏等并发症，一期愈合。均获得随访，平均随访29个月(10~60个月)。所有病例未发生内置物断裂、松动移位和椎间隙高度丧失等并发症，骨融合率为91%。依据日本JOA疗效评定标准，优35例，良26例，可5例，差2例，总优良率为90%。结果说明基于椎弓根置入内固定的椎间孔入路腰椎体间植骨融合可有效治疗腰椎退行性疾病，近期随访结果满意。

关键词: 经腰椎间孔入路, 椎间融合, 椎弓根固定, 腰椎退行性疾病, 硬组织植入物

Abstract:

BACKGROUND: Lumbar spinal fusion has widely used in treating lumbar degenerative disease. However, the fusion rates of traditional posterior or posterolateral fusion are low, and companied by more complications, which affect adjacent segment stability and destroy distribution of mechanical loading in vertebral column.
OBJECTIVE: To evaluate clinical efficacy for the treatment of lumbar degeneration with transforaminal lumbar interbody fusion (TLIF) based on pedical fixation.
METHODS: A total of 68 patients with lumbar degeneration were treated with TLIF and pedical screw fixation，including 24 cases of isthmus spondylolisthesis, 16 cases of degenerative lumbar spondylolisthesis, 18 cases of degenerative lumbar spinal stenosis and 10 cases of lumbar intervertebral disc degeneration.
RESULTS AND CONCLUSION: There were no complications of neurologic damage，infection of lumbar vertebrae interspace or cerebrospinal leakage. All patients were follow-up for 29 months (10-60 months). There were no inner fixation breakage and loosing, and no disc space height losing in all cases. Intervertebral fusion rate was 91%. Japanese Orthopaedic Association (JOA) score showed 35 cases were excellent, 26 good, 5 improved and 2 worse, with 89.71% excellent and good rate. TLIF based on pedical screw fixation is an effective method for the treatment of lumbar degeneration. The short-term results are satisfied.

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