腰椎后路单Cage单侧椎体间融合术在腰椎退变性疾病中的应用

Posterior lumbar interbody fusion using a unilateral single cage in the degenerative lumbar spine

目的对单Cage单侧PLIF治疗腰椎退变性疾病的临床疗效及放射影像学结果进行回顾性分析。方法 2005年10月至2008年3月间,使用填有移植骨的单Cage单侧PLIF技术为55例腰椎退变性疾病患者施行手术,术中将腰椎后路减压所取下的骨块咬碎后填于Cage前方,术后平均随访39.2个月。使用VAS法对患者的术前、术后1年及末次随访进行临床评估,用ODI法对术前及末次随访的功能进行评估,在末次随访中使用Prolo评分法,放射影像学可通过椎间高度、Cage周围的骨桥、射线透亮区及过伸过屈侧位片上椎间不稳的表现来评估。结果 VAS评分、ODI指数、Prolo评分均表明该术式的临床疗效非常令人满意,放射影像学评估显示术后6月时55例中有96.4%(53例)获牢固融合,末次随访时所有病例均获得完全融合。结论单Cage单侧PLIF治疗腰椎退变性疾病,能维持合适的椎间高度,有可靠的脊柱稳定性、良好的骨连接和较高的骨融合率,可获得令人满意的临床疗效和放射影像学结果。

Objective We retrospectively evaluated the clinical and radiological outcomes of posterior lumbar interbody fusion （PLIF） using a unilateral single cage and a local morselized bone graft. Methods Fifty five patients who underwent PLIF with a unilateral single cage filled with local morselized bone graft were enrolled in this study. The average follow-up duration was 39.2 months. The clinical outcomes were evaluated with the visual analogue scale （VAS） at the pre-operative period, at 1 year post-operation and at the final follow-up, the Oswestry Disability Index and the Prolo scale at the final follow-up; the radiological outcomes were evaluated according to the change of bone bridging, the radiolucency, the instability and the disc height. Re,tits For the clinical evaluation, the VAS pain index, the Oswestry Disability Index and the Prolo scale showed excellent outcomes. For the radiological evaluation, 55 cases showed complete bone union at the final follow-up. Conclusion PLIF using a unilateral single cage filled with a local morselized bone graft for treating degenerative lumbar spine disease provides excellent outcomes according to the clinical and radiological evaluation.