螺纹椎体间融合器治疗腰椎节段性不稳症-中医骨伤专业毕业论文.docxVIP

P P 8011《2 提要 目的：了解应用螺纹椎体间融合器(TFC)治疗腰椎节段性不稳(LSSI)症的疗 效及并发症。 方法：2000年2月一2002年11月间19例LSSI症的患者以椎体间TFC行后路 椎体间融合术。全部患者均在一个椎间隙植入2枚同样规格的TFC，合并椎管狭窄 者予彻底减压、神经根管扩大松解。 结果：无神经根损伤等严重并发症。一例患者术中出现硬脊膜破裂，予以修补， 术后未出现脑脊液漏的临床表现。2例患者术后出现轻度下肢放射痛(术前无)，3 周后消失。随访期末，17例植骨已融合。本组优良率94．7％。 结论：应用TFC治疗LSSI症是一种比较先进、合理的方法。近期疗效优异， 但其远期疗效尚需进一步观察。 关键词：腰椎节段性不稳症；TFC；手术治疗、 THREADED THREADED FUS I ON CAGE AND I TS USE I N TREATMENT OF LUMBA SPl NAL SEGMENTAL I NSTABI Ll TY Speciality：orthopaedics of TCM Postgraduate：Wang Qinghang Tutor：Prof．Dong Jianwen Abstract 0bject i ve：To assess the complications and outeomesof patients with threaded fusion TFCs implanted into their 1umbar vertebrals． Method：Nineteen patients(mean age，48．2 years；range29—62 years) were treated with posterior lumbar interbody fusion using threaded fusion TFCs．All patients were implanted two TFCs in one segment．Preoperative CT scanning and plain radiography was used to measure endplate dimensions and template the appropriately sized interbody fusion TFCs． Result：No TFC failure or extrusion was observed．No neurologic deficits occurred．One cerebral spinal fluid leaked．The operative results were rated as excellent，good，fair，or poor．The overall fusion rate was 89．5％．The good or excellent rate was 94．7％． Conc I US i on：This study demonstrates that the threaded fusion cage offers a useful alternative to the more traditional posterior lumbar interbody fusion procedure．There were fewer complications with the threaded fusion cage technique．Although this study has investigated the acute effects of the TFC，lortg-term clinical outcomes studies are necessary to address issues concerning the clinical effectiveness of these procedures． Keywo rds：Lumbar spinal segmental instability；Threaded fusion cage； Operative treatment 坚竺苎堡苎苎全墨竺堕壁堡芏垦兰!兰生————．——引言 坚竺苎堡苎苎全墨竺堕壁堡芏垦兰!兰生————．—— 引言 腰椎节段性不稳(1umbar spinal segmental instability，LSSI)既是脊柱疾患中的一个 病理现象，也是一个症候群，也可以是一个独立的疾患。近年来，随着脊柱外科理论 与技术的发展，临床经验也证实了伤残性的腰腿痛与腰椎不稳密切相关。Kulisch和 其同事在1991年表明，活动节段的关节紊乱在没有神经压迫或者过度