可膨胀性椎间融合器在腰椎退行性疾病治疗中的临床应用

Application of expandable spinal spacer in lumbar degenerative disease

目的:探讨可膨胀性椎间融合器治疗腰椎退行性疾病的效果。方法:2009年4月～2010年5月我院对50例患者采用可膨胀性椎间融合器治疗腰椎退行性疾病,其中采用后路椎间盘镜下操作治疗的有41例,采用后外侧经皮穿治疗的有9例。回顾性分析其临床资料,对其治疗效果、植骨融合率、椎间隙高度及并发症等进行分析。结果:术后随访时间8～38个月,平均16个月,按照Odom标准对治疗效果进行评价。结果显示,36例为优,占72%;9例为良,占18%;4例为可,占8%;1例为差,占2%。患者的症状得到明显改善,其优良率达90%。CT影像显示椎间盘突出并椎管严重狭窄,椎间融合器没有移位现象,与骨已融合,椎间高度没有明显下降。术后对患者进行随访仅有3例出现并发症,占6%。结论:可膨胀性椎间融合器治疗腰椎退行性疾病,具有创伤小、安全性高、融合率高、恢复良好等优点,具有很好的应用前景,值得进行临床推广应用。

Objective： To explore the clinical therapeutic effect of expandable spinal spacer in lumbar degenerative disease.Methods： 50 patients in lumbar degenerative disease were treated with expandable spinal spacer from April 2009 to May 2010 in our hospital,of which there were 41 cases who obtained the microscopic posterior disc operation treatment,9 cases who obtained the lateral percutaneous wear treatment.The clinical data of treatment effect,fusion rate,bone graft height and complications were analyzed retrospectively.Results： In the follow-up time for 8-38 months,the effects were evaluated according to the standard of Odom.The results showed that,36 cases were excellent,accounting for 72%;9 cases were well,accounted for 18%;4 cases were common,accounted for 8%;1 case was inferior,accounted for 2%.The symptoms of patients improved obviously,its good rate could amount to 90%.CT image showed that there was no disc herniation and vertebra canal stenosis,and also no shift phenomenon between vertebra and expandable spinal spacer,the bone had merged,bone graft height had not obviously decreased.Patients were followed up with the results of only 3 cases of complications with the incidence rate was 6%.Conclusion： Expandable spinal spacer applied to treat the lumbar degenerative disease has small trauma,high safety,fusion rate high,good restore and other advantages,which has a good application prospect and is worthy of clinical application.