cage联合椎弓根螺钉在不稳定性腰椎管狭窄症中的应用

Application of interbody fusion and pedicle screw in the instability of lumbar spinal stenosis

目的探讨cage联合椎弓根螺钉在不稳定性腰椎管狭窄症治疗中的临床疗效。方法对17例不稳定性腰椎管狭窄症患者采取后路椎管减压和椎弓根螺钉固定,椎间隙植碎骨融合,从一侧由后斜向前呈45°置入cage。结果随访15～28个月(平均21个月)。症状改善率82.4%,椎体融合率88.2%。3例椎间隙高度丢失1～1.5mm,3例出现固定相邻上或下腰椎不稳。未出现螺钉松动、断裂及cage明显后移。术后3例椎体滑移基本矫正,2例滑移小于1.5mm。结论cage联合椎弓根螺钉治疗不稳定性腰椎管狭窄症,症状改善明显,能有效复位椎体及恢复椎间隙高度,稳定椎体,提高融合率,是一种有效的治疗方法。

Objective To evaluate the clinical efficacy of interbody fusion cage and pedicle screw in the treatment of instability lumbar spinal stenosis. Methods 17 cases of instability with lumbar spinal steno- sis recieved posterior spinal decompression and pedicle screw fixation, implanted bone fragments within the intervertebral fusion,and interbody fusion cage was implanted from the side of the vertebral body,from back to front by 45°. Results The period follow-up was 15-28 months（ averaged 21 months） and there were 82.4% of patients symptoms improved and 88.2% of patients were vertebral fusion. There were 3 cases of intervertebral space height lost for 1 - 1.5 mm and were 3 cases of lumbar spine unstable in the adjacent fixed lumbar. All the patients were without internal fixation loosening and rupture. After the operation, there were three cases with ver- tehral slip the basic correction and two cases of slippage are less than 1.5 ram. Conclusion It is a safe and ef- fective method to treat unstable lumbar spinal stenosis by pedicle screws and interbody fusion cage, and can sig- nificantly improve the symptoms, effectively reset the vertebral body and restore intervertebral height, stable ver- tebral body,improve the rate of interbody fusion.