单侧椎弓根螺钉加颗粒骨椎间植骨治疗退行性腰椎不稳的疗效观察

Observation of clinical effect of unilateral pedicle screw fixation with intervertebral morselized bone body fusion after decompression in treating degenerative lumbar instability

目的观察减压后采用单侧椎弓根螺钉加颗粒骨椎间植骨融合术治疗退行性腰椎不稳症的疗效。方法1996年6月至2009年10月我科19例退行性腰椎不稳症患者减压后采用单侧椎弓根螺钉内固定加颗粒骨椎间植骨融合。手术前以及末次随访时按日本矫形外科学会（JOA）腰腿痛疗效标准（29分法）进行评价，计算改善率和优良率，并随访观察植骨融合情况。结果术中出血平均160mL，手术时间平均105min。随访14-45个月（平均23个月），末次随访时JOA评分与术前比较差异有统计学意义（P〈0．05），JOA评分改善率90．7％，优良率94．2％。结论单侧椎弓根螺钉加颗粒骨椎间植骨是治疗轻度退行性腰椎不稳可供选择的较好方法。

Objective To investigate the surgical outcome of unilateral pedicle screw fixation with intervertebral morselized bone body fusion after decompression for degenerative lumbar instability. Methods From June 1996 to February 2009, 19 cases of degenerative lumbar instability who underwent a unilateral pedicle screw fixation with intervertebral morselized bone body fusion after decompression were reviewed retrospectively. JOA 29 score system was used to evaluate the neurological function. The excellent rate, improvement rate as well as fusion status were reviewed ret rospectively. Results The average blood loss was 160mL during operations. The average operation time was 105 rain in group. After an average of 23 months followup（range 14- 45 months）, JOA score at final follow - up had significant difference compared with preoperative counterparts （ P 〈 0.05）. And the improvement rate was 90.7 %, and the excellent rate was 94.2 %. Conclusion Unilateral pedicle screw fixation with intervertebral morselized bone body fusion after decompression is optional for light degenerative lumbar instability.