单侧及双侧椎弓根螺钉固定加椎间融合治疗腰椎退行性疾病的临床疗效分析.pdfVIP

提 要 目的：观察单侧和双侧椎弓根螺钉固定加椎间植骨融合治疗腰椎退行性疾病的临 床疗效，分析腰椎单侧椎弓根螺钉固定加椎间植骨融合的生物力学稳定性。 方法：对2009年3月到 2011年10月病房收治的68例具有完整资料的腰椎退行 性疾病患者进行回顾性分析，其中32例减压后采用单侧椎弓根钉内固定，36例减压 后采用双侧椎弓根钉内固定，所有病例均同时行椎间植骨融合。比较两组手术时间、 术中出血量，并根据VAS 评分和JOA(日本骨科协会评估治疗分数)评分评估治疗前后 腰椎功能改善情况，计算改善率，随访观察植骨融合情况。 结果：比较两组的手术时间和出血量，单侧组少于双侧组，差别有统计学意义 （P0．05）。术后 68 例获得 3～9 个月随访，平均 6 个月，随访期间均未发现 Cage 移位或下沉、椎弓根螺钉松动断裂。VAS评分和JOA评分同组术前术后比较有显著性 差异 (P0．01)。 结论：单侧与双侧椎弓根螺钉固定加椎间植骨融合都能使腰椎获得可靠的稳定 性，与后者比较，前者手术方法简单，并且可缩短手术时间，减少出血量，减少并发 症。 关键词 单侧固定 腰椎融合 腰椎退行性疾病 生物力学 Clinical study of unilateral and bilateral pedicle screw fixation with intervertebral body fusion in treating lumbar degenerative disease Speciality：Orthopedics of TCM Author ：Su Yang Tutor ：Prof. Hao Yanke Abstract Objective: To observe the surgical outcome of unilateral and bilateral pedicle screw fixation with intervertebral body fusion for lumbar degenerative disease, analysis biomechanical stability of unilateral pedicle screw fixation with intervertebral body fusion. Methods: From March 2009 to October 2011 ， 68cases of patients with lumbar spine degenerative disease which have a complete data were retrospectively analyzed.Among them, 32 cases underwent a unilateral pedicle screw fixation after decompression ,while 36 cases experienced a bilateral pedicle screw fixation after decompression ,as all cases were treated with intervertebral body fusion. It is aimed to make a comparison between the two sets of operation time and their peri-operative bleeding. Besides, according to the VAS and JOA(Japanese orthopaedic association treatment evaluation score) score, it is aimed to evaluate