撑开型椎间融合器在腰椎不稳症治疗中应用

Expandable interbody cage in treatment of lumbar instability disease

目的 探讨撑开型椎间融合器在腰椎不稳症治疗中的临床疗效。方法 自2004年1月至2006年9月，对52例腰椎不稳症患者单纯性应用撑开型椎间融合器进行治疗，测量患者手术前后椎间隙前凸角度以及应力位片椎体间角度活动域，临床疗效采用Oswestry功能障碍指数（oswestry disability index，ODI）对患者术前、术后的症状进行评定，同时观察融合率和并发症。结果 患者全部获得随访，随访时间9—24个月，平均18个月。融合率100％，融合节段椎间隙前凸角度5．3±1．2°，动力位片术前椎间活动域：19．2°±1．4°，术后椎间活动域：4．3°±0．5°（P〈0．01）。全部患者未发生融合器脱出、塌陷、移位等并发症，按照ODI评分疗效判定法，术后优良率及末次随访优良率分别为90．1％及93．5％。结论 使用撑开型椎间融合器治疗腰椎不稳症，具有手术简单、创伤小、疗效好、且无须辅助后路椎弓钉固定即可达到即时的腰椎稳定性。重建了椎间隙的前凸，保持了椎间隙高度，腰椎生物力学功能恢复好，具有较好的临床应用前景。

Objective To explore clinical outcomes of expandable interbody cage system in treating lumbar instability disease. Methods A retrospective study was made in 52 cases with lumbar instability treated by expandable interbody cage from Jan. 2004 to Sep. 2006, and the lumbar interbody lordosis angle and domain of sagittal rotation were be measured. The Oswestry disability index （ODI） was used to evaluate the clinical outcome, and symptom and fusion rate were observed. Results All patients were followed-up 9 months to 24 months, 18 months average. Fusion rate was 100%. Lumbar interbody lordosis angle was 5.3°±1.2°, dynamic domain of sagittal rotation decreased significantly, without sympton of prolapse, sink and dislocation in all patients, 93.5% patients showed excellent clinical our come. Conclusion Using expandable interbody cage to treat lumbar instability disease had simple mininvasive good clinical outcome. It can get stabilization without combind with pedicle screw, reconstruct the lumbar lordosis preserve, the disc space height and restore lumbar alignment.