Cage植骨结合椎弓根螺钉系统内固定术治疗腰椎退行性疾病的临床应用

Clinical application of Cage bone-implatation conjugating lag screw system internal fixation of vertebral arch pedicle in treatment of lumbar regressive disease

目的评估Cage植骨结合椎弓根螺钉系统内固定术治疗腰椎退行性疾病的疗效。方法采用Cage植骨结合椎弓根螺钉系统内固定术治疗腰椎退行性疾病65例,观察其疗效和并发症。结果所有患者症状明显改善。术后1周按Odom标准评估疗效:优43例;良15例;可7例,优良率达89.2%。所有患者随访3～24个月,末次随访按Odom标准评估疗效:优45例;良16例;可4例,优良率达93.8%。经X线检查,所有患者术后3个月椎体间Cage植骨均达到骨性融合,椎弓根螺钉无断裂,Cage无后移、沉陷,椎间隙高度无明显丢失。近期并发症:神经症状加重4例,脑脊液漏2例;远期并发症:神经症状残留3例。结论椎弓根螺钉技术和Cage植骨融合术的联合应用可以优势互补,降低各自术式的并发症,使脊柱稳定性增加,植骨融合率高,提高了临床疗效,有较大的临床应用价值。

Objective To evaluate the effects of Cage bone-implatation conjugating lag screw system internal fixation of vertebral arch pcdicle in treatment of lumbar regressive disease. Methods 65 cases of lumbar regressive disease were treated by Cage bone-implatation conjugating lag screw system internal fixation of vertebral arch pedicle, and their effects and comphcations were observed. Results Symptoms of all cases were obviously ameliorated, with 4 patients neural symptoms aggravation and 2 ce- rebrospinal fluid leak as immediate complications, and 3 neural symptoms remaining as long-term neural symptoms. Effect evaluation one week after operation according to Odom Criterion were 43 cases excellent, 15 fine and 7 acceptable, thus excellent and fine ratio was 89. 2%. All cases were foUowed-up for 3 to 24 months, effect evaluaion of the last follow-up according to Odom Criterion were 45 cases excellent, 16 fine and 4 acceptable, thus excellent and fine ratio was 93.8%. After X-ray examination, all cases achieved osseous fusion of Cage bone-implatation between vertebral bodies, with no rupture of lag screw of vertebral arch pedicle, no Cage retrocession or sinking, and with no obvious loss of intervertebral space height; COnclusion Combination of lag screw of vertebral arch pedicle techniques and Cage bone-implatation fusion can work out complementation of each other＇s superiorities, reduce complications of each own, magnificantly increase spinal stability, and raise fusion ratio of bone-implatation, thus in- crease clinical effects and possess higher clinical application value.