棘突骨块在腰椎后路椎体间融合术中的应用
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摘要
目的:探究棘突骨块在腰椎后路椎体间融合术中的应用。方法:选取70例行腰椎后路椎体间融合术治疗的患者为研究对象,采用随机数字表法分为常规组与干预组,每组35例,给予常规组Cage植骨融合,干预组给予自体棘突骨块融合,随访两组患者6～24个月,对比治疗效果。结果:干预组优良率为94.29%,与常规组91.43%相比,差异无统计学意义(P>0.05)。干预组术后12个月VAS疼痛评分、椎间高度、腰椎前凸角与常规组相比,差异无统计学意义(P>0.05)。干预组植骨融合率为94.29%,常规组植骨融合率为91.43%,差异无统计学意义(P>0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:Cage植骨融合与自体棘突骨块融合均可用于腰椎后路椎体间融合术,效果相似。
Objective: To explore application of interspinous bone blocks in the posterior lumbar interbody fusion. Methods: 70 patients, who underwent the posterior lumbar interbody fusion, were selected as the study subjects. They were divided into conventional group(n=35) and intervention group(n=35) according to the random number table method. The conventional group was given the conventional cage fusion with bone grating, while the intervention group used the autologous interspinous block fusion. The two groups were followed up for 6 to 24 months to compare the therapeutic effects. Results: The excellent and good rates of the intervention group and the conventional group were 94.29% and 91.43%, respectively, and the difference was not statistically significant(P>0.05). After the intervention, there were no significant differences in the pain VAS score, intervertebral height, lumbar lordosis angle between the intervention group and the conventional group(P>0.05). The bone grafting fusion rate was 94.29% in the intervention group and 91.43% in the reference group, and the difference was not statistically significant(P>0.05). There was no significant difference in the incidence of complications between the two groups(P>0.05). Conclusions: Cage fusion with bone grafting and autologous interspinous block fusion both can be used for posterior lumbar interbody fusion with similar results.
Objective: To explore application of interspinous bone blocks in the posterior lumbar interbody fusion. Methods: 70 patients, who underwent the posterior lumbar interbody fusion, were selected as the study subjects. They were divided into conventional group(n=35) and intervention group(n=35) according to the random number table method. The conventional group was given the conventional cage fusion with bone grating, while the intervention group used the autologous interspinous block fusion. The two groups were followed up for 6 to 24 months to compare the therapeutic effects. Results: The excellent and good rates of the intervention group and the conventional group were 94.29% and 91.43%, respectively, and the difference was not statistically significant(P>0.05). After the intervention, there were no significant differences in the pain VAS score, intervertebral height, lumbar lordosis angle between the intervention group and the conventional group(P>0.05). The bone grafting fusion rate was 94.29% in the intervention group and 91.43% in the reference group, and the difference was not statistically significant(P>0.05). There was no significant difference in the incidence of complications between the two groups(P>0.05). Conclusions: Cage fusion with bone grafting and autologous interspinous block fusion both can be used for posterior lumbar interbody fusion with similar results.
引文
[1]陈浩,张体栋,贾璞,等.BacFuse棘突间植入术和后路椎间融合固定术治疗腰椎间盘突出症的对比研究[J].临床和实验医学杂志,2016,15(5):471-474.
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[6]封亚平,封雨,邓洵鼎,等.单纯后路手术治疗胸腰椎结核临床疗效分析[J].中华神经外科疾病研究杂志,2017,16(6):534-537.
[7]伍红桦,屈波,潘显明,等.椎弓根钉固定并单Cage单侧椎体间骨粒植骨融合技术在慢性下腰痛中的应用[J].西北国防医学杂志,2014,35(2):161-163.
[8]李少辉,王平均,李斌,等.单边内固定联合椎间cage植骨融合治疗单侧相邻两节段腰椎间盘突出症[J].临床骨科杂志,2017,20(1):23-25.
[9]刘超杰,覃大海.后路椎间盘摘除椎弓根钉内固定结合Cage植骨治疗腰椎间盘突出症的临床分析[J].吉林医学,2016,37(12):2926-2927.
[10]宋红芳,张雯,张强,等.融合与非融合稳定方式对损伤性腰椎活动影响的对比[J].中国组织工程研究,2017,21(31):4963-4968.
[11]符楚迪,葛云林,李战友.应用不同融合材料的腰椎后路椎体间融合术临床对比[J].浙江医学,2016,38(23):1931-1933.
[12]梁涛.探讨后路椎间盘摘除椎弓根钉内固定结合cage植骨治疗腰椎间盘突出症的临床效果[J].中国卫生标准管理2016,37(12):47-48.
[13]吕辉照,陈阳,赵枫,等.后路单双枚Cage椎间融合治疗腰椎滑脱临床疗效比较[J].颈腰痛杂志,2012,33(4):249-252.
[14]王景宏.两种椎间植骨融合法在治疗腰椎滑脱症中的疗效观察[J].饮食保健,2017,4(2):48-49.
[15]农丕地,刘江山,周永军.椎管减压后侧棘突骨块植骨加椎弓根钉棒系统内固定治疗腰椎不稳[J].右江民族医学院学报,2011,33(4):462-463.
[2]邓建龙,陈晓勇,王剑敏,等.棘突骨块在腰椎后路椎体间融合术中的应用[J].中国骨与关节损伤杂志,2018,33(9):971-973.
[3]Kirkaldy-Willis SH.Managing low back pain[M].New York:Churchill Livingstone Inc,1992:49-74.
[4]Suk SI,Lee CK,Kim WJ,et al.Adding posterior lumbar interbody fusion to pedicle screw fixation and posterolateral fusion after decompression in spondylolytic spondylolisthesis[J].Spine(Phila Pa1976),1997,22(2):210-220.
[5]沈友银,杨月舟,汤龙海,等.棘突间钢丝内固定在胸腰椎骨折合并后方韧带复合体分离损伤治疗中的应用[J].中国骨与关节损伤杂志,2017,32(1):60-62.
[6]封亚平,封雨,邓洵鼎,等.单纯后路手术治疗胸腰椎结核临床疗效分析[J].中华神经外科疾病研究杂志,2017,16(6):534-537.
[7]伍红桦,屈波,潘显明,等.椎弓根钉固定并单Cage单侧椎体间骨粒植骨融合技术在慢性下腰痛中的应用[J].西北国防医学杂志,2014,35(2):161-163.
[8]李少辉,王平均,李斌,等.单边内固定联合椎间cage植骨融合治疗单侧相邻两节段腰椎间盘突出症[J].临床骨科杂志,2017,20(1):23-25.
[9]刘超杰,覃大海.后路椎间盘摘除椎弓根钉内固定结合Cage植骨治疗腰椎间盘突出症的临床分析[J].吉林医学,2016,37(12):2926-2927.
[10]宋红芳,张雯,张强,等.融合与非融合稳定方式对损伤性腰椎活动影响的对比[J].中国组织工程研究,2017,21(31):4963-4968.
[11]符楚迪,葛云林,李战友.应用不同融合材料的腰椎后路椎体间融合术临床对比[J].浙江医学,2016,38(23):1931-1933.
[12]梁涛.探讨后路椎间盘摘除椎弓根钉内固定结合cage植骨治疗腰椎间盘突出症的临床效果[J].中国卫生标准管理2016,37(12):47-48.
[13]吕辉照,陈阳,赵枫,等.后路单双枚Cage椎间融合治疗腰椎滑脱临床疗效比较[J].颈腰痛杂志,2012,33(4):249-252.
[14]王景宏.两种椎间植骨融合法在治疗腰椎滑脱症中的疗效观察[J].饮食保健,2017,4(2):48-49.
[15]农丕地,刘江山,周永军.椎管减压后侧棘突骨块植骨加椎弓根钉棒系统内固定治疗腰椎不稳[J].右江民族医学院学报,2011,33(4):462-463.