椎体间融合治疗腰椎间隙狭窄症的临床疗效分析

The clinical analysis of therapeutic efficacy in the treatment of spinal stenosis by interbody fusion.

目的 分析各种椎体间融合术治疗椎间隙狭窄症的临床疗效,及其适应证。方法 采用后路全椎板减压椎体间植骨加节段内固定、后路全椎板减压双Cage植入或加用节段内固定、后路半椎板减压单Cage植入或加用节段内固定、前路椎体间撑开植骨及前路椎体间撑开双Cage植入等术式治疗腰椎间隙狭窄症84例并对疗效、适应证进行分析总结。结果 全部病例随访10-24个月,临床疗效优良率为90.5％,植骨融合率为91.7％（其中自体骨植骨融合率为84.0％,Cage植骨融合率为93.2％）,椎间隙恢复高度为11.4mm（其中自体骨恢复高度为10.6mm,Cage恢复高度为11.8mm）。结论 椎体间植骨融合治疗椎间隙狭窄症具有疗效好、植骨融合率高等优点,根据不同病因选择不同术式治疗,能减少损伤、提高疗效、缩短康复时间。

Objective To analyse the clinical outcome in treatment of spinal stenosis by various lumbar interbody fusions and evaluate their surgical indications. Methods Lumbar interbody fusion with a variety of operations were performed in 84 cases with spinal stenosis . The posterior lumbar interbody fusion by autograft or two threaded fusion cages with bilateral laminectomy , and the anterior lumbar interbody fusion two threaded fusion cage with unilateral laminectomy were adopted. Results All the cases were followed-up 10-24 months, and had a excellent and good rate of 90.5% after two years. the fusion rate was 90.47%.(that of single autograft was 84.0%, and that of fusion cage with autograft was 93.2% ) . The intervertebra space was increased to 11.4mm, averagely(the single autograft side was increased to 10.6 mm , and the fusion cage with autograft was increased to 11.8 mm ) . Conclusion Lumbar interbody fusion to treat spinal stenosis offers a safe, effective means with clinical and functional improvement. In the clinical setting, in order to reduce the damage, improve the clinical outcome and shorten the convalescent periods, we should adopt various operations in terms of different patient conditions.