保留终板均匀颗粒骨打压植骨结合内固定治疗腰椎不稳症

Pedicle screw fixation and posterior lumbar interbodoy fusion with Preserving Endplates and morselized impacted bone graft in treatment of lumbar instability

目的探讨保留终板、均匀颗粒骨椎间打压植骨结合内固定治疗腰椎不稳症的临床疗效。方法选择2005年4月至2009年10月期间,因腰椎不稳症在我院行保留终板、均匀颗粒骨椎间打压植骨结合内固定治疗,获得完整随访资料的病例23例。观察临床疗效及椎间融合情况。结果所有患者原有神经压迫症状消失,术后JOA评分较术前明显提高(P<0.05),Oswestry功能障碍指数较术前明显减少(P<0.05)。术后、最终随访较术前椎间隙高度明显增高(P<0.05)。椎间融合率约为95.7%,JOA评分优良率87.0%。结论后路保留终板、均匀颗粒骨打压植骨行腰椎间融合术结合内固定治疗腰椎不稳症,手术操作相对简单,融合率高,同时具有医疗费用低、并发症少的优点,是一种可选择的治疗方法。

Objective ： To evaluate the clinical efficacy of pedicle screw fixation and posterior lumbar interbody fusion with Preserving Endplates and morselized impacted bone graft in treatment of lumbar instability. Methods： Between March 2005 and October 2009, 23 patients with instability of lumbar were treated with this method. Observation of the clinical ef- ficacy, fusion rate and interbody space height was made. Results： The symptoms signs were released. The comparison was made about preoperative and postoperative JOA scores, Oswestry index and intervertebral height （ P 〈 0.05 ）, fusion rate was 95.7%, and excellent rate was 87.0%. Conclusion： The method is an effective way of treating lumbar instability. This way is simple and cheap, with advantages of less injury and high fusion rate. Key words ： lumbar instability; interbody fusion; bone graft; pedicle screw