棘突根部与椎板连接复合体椎间植骨结合椎弓根钉棒系统内固定治疗腰椎不稳的临床研究

Clinical Study of Lumbar Interbody Fusion with Bone Structure from Spinous Process Root to Vertebral Lamina and Transpedicular Fixation in Treating Lumbar Instability

目的研究棘突根部与椎板连接复合体椎间植骨结合后路椎弓根钉棒系统进行腰椎融合治疗腰椎不稳及退行性疾病的手术方法,以期为临床提供一种较为理想的椎间植骨选择。方法A组41例腰椎不稳及退行性疾病,为对照组,行椎间自体髂骨块植骨;B组46例腰椎不稳及退行性疾病,为实验组,行椎间自体棘突根部与椎板连接复合体植骨,对两组患者的手术时间、失血量、住院时间、疼痛改善、融合率以及融合所需时间和影像学测量结果均进行记录比较。结果两组在手术时间、失血量、住院时间、疼痛缓解评分程度、融合率以及融合所需时间等均无明显差异,但在维持椎间隙高度及减少腰椎滑移危险方面有显著性差异。结论棘突根部与椎板连接复合体椎间植骨结合椎弓根钉棒系统内固定治疗腰椎不稳及退行性疾病手术方法可行有效,在维持椎间隙高度与减少腰椎滑移方面有较好效果,是一种较为理想的腰椎融合方法。

Objective To explore the treatment outcome of the bone conjunction structure in interbody fusion for lumbar instability and other degenerative diseases, and provide a reasonable clinical choice for lumbar interbody fusion. Methods All cases were divided into two groups. In group A as control group, 41 cases underwent interbody fusion with self- lilac bone graft. In group B as experimental group, 46 cases underwent interbody fusion with, the structure from spinous process root to vertebral lamina. The operation times and volume of blood loss and days in hospital and pain improvement and rates of bone fusion, and the time of fusion, imaging measurements outcomes were recorded and compared. Results The differences were significant between the two groups, but not significant in other aspects. Conclusion The approach of lumbar interbody fusion with the structure from spinous process root to vertebral lamina combined with transpedicular fixation is feasible and effective in treating lumbar instability and other degenerative diseases. It can better maintain the height of intervetebral space and reduce the danger of lumbar displacement.