显微椎间盘镜下B-Twin椎间融合术治疗腰椎退变失稳型椎间盘突出症

Microendoscopic Decompression and Interbody Fusion with B-Twin for Degenerative Unstable Lumbar Disc Herniation

目的探讨后路显微椎间盘镜下可膨胀性椎间融合器B-Twin植入椎间融合术治疗腰椎退变失稳型椎间盘突出症的临床疗效。方法 2005年9月~2008年6月,对32例腰椎退变失稳型椎间盘突出症行后路显微椎间盘镜联合可膨胀性椎间融合器B-Twin植入椎间融合术。手术融合节段：L2/31例,L3/43例,L4/518例,L5/S110例,均为单节段。结果植入2枚B-Twin 23例,单枚9例。术后1周VAS疼痛评分由术前8.7±0.3降至2.3±1.7（t=20.64,P=0.001）。随访时间平均25个月（24~29个月）,植骨融合率采用Suk标准：1年融合率为93.8%（30/32）,2年融合率为96.9%（31/32）,B-Twin椎间融合器无明显下沉。结论后路显微椎间盘镜联合可膨胀性椎间融合器B-Twin植入椎间融合术治疗腰椎退变失稳型椎间盘突出症创伤小,植骨融合率高,临床症状缓解满意。

Objective To investigate the efficacy of microendoscopic decompression and interbody fusion with B-twin for the patients with degenerative lumbar disc herniation with a unstable disc. Methods From September 2005 to June 2008,32 cases of unstable herniation of the lumbar disc with degeneration received microendoscopic decompression and interbody fusion with expandable spinal spacer of B-Twin.The operational segments included L2/3（1 case）,L3/4（3 cases）,L4/5（18 cases）,and L5/S.1（10 cases）.All of the cases were single segmental. Results In the 32 patients,two pieces of B-twin were employed in 23 cases,and single piece in the other 9.One week after the operation,the VAS pain score decreased from 8.7±0.3 to 2.3±1.7（t=20.64,P=0.001）.The patients were followed up for a mean of 25 months（24-29 months）,during which,based on the Suk criteria,1-year fusion rate was 93.8%（30/32）,and the 2-year rate was 96.9%（31/32）.No patients showed subsidence of the B-twin. ConclusionsMicroendoscopic decompression and interbody fusion with B-twin through the back route is effective for degenerative unstable herniation of the lumbar disc with less surgical trauma and higher fusion rate.