环锯加盖植骨法在腰椎椎间植骨融合中的临床研究

Clinical Application of Trepan Stamp Graft in Lumbar Interbody Fusion

目的探讨环锯加盖植骨法在经后路腰椎椎间植骨融合的可行性和临床价值.方法将2000年1月至2008年4月因腰椎疾患术后需要植骨融合的60例患者随机均等分成观察组和对照组,采用环锯加盖植骨法的病例设为观察组,使用椎间融合器的病例设为对照组,比较两组的融合时间、融合率,椎间高度的变化及有无并发症.结果术后60例随访时间6～24个月,平均14个月.对照组有4例患者术后3个月术后出现椎间融合器向后移位(<2 mm),其中1例出现神经根受压表现.1例患者术后6个月出现椎间融合器下沉,下终板塌陷.观察组与对照组术后椎间植骨融合率和术后随访椎间隙高度丢失的比较无统计学意义(P>0.05).观察组较对照组的融合时间提早,其早期融合率有统计学意义(P<0.05).结论环锯加盖植骨法是一种经济、有效的腰椎椎体间融合方法,值得临床推广.

Objective To explore the feasibility fusion. Methods From January 2000 to April 2008, and clinical value of trepan stamp graft in lumbar interbody sixty patients with lumbar disease who need lumbar fusion were randomly divided into 2 groups ： observation group and control group. Patients in the observation group were given trepan stamp graft, and patients in the control group were given intervertebral fusion cage. The fusion time, fusion rate, intervertebral height changes, and complications were compared between the two groups. Results Sixty patients were followed up for 6 to 24 months, an average of 14 months. In the control group, cage backward shift （ 〈 2 mm） was found in 4 patients 3 months after operation, including 1 patient with nerve root compression sign, cage subsidence and endplate collapse was found in 1 patient. There was no statistically difference in the postoperative interbody fusion rate and disc height loss between the observation group and control group （P 〉 0.05 ）. The fusion time of patients in the observation group was earlier than that in the control group, and there was a statistically significant difference in the early fusion rate between the two groups （P 〈 0.05）. Conclusion Trepan stamp graft is an economical and effective lumbar interbody fusion method, and deserves to generalize in clinic.