腰椎间盘突出症翻修术中单、双枚椎间融合器的应用效果

Efficacy of revision surgery for lumbar intervertebral disc herniation with one or two Cages

目的:比较腰椎间盘突出症翻修术中椎弓根螺钉内固定并单枚椎间融合器(Cage)加周围松质骨植入与双枚Cage植入椎间融合术的应用效果。方法:15例接受腰椎间盘突出症翻修术的患者根据病变节段椎体横径大小,分别采用单枚Cage加周围松质骨植入(A组,n=7)和双枚Cage植入(B组,n=8)。术后随访6个月～2a,评估术前、术后3d及24周时患者的腰椎椎间隙高度、腰椎融合率,并进行下腰疼JOA评分。结果:2组L4/L5、L5/S1腰椎间隙高度和下腰疼JOA评分差异均无统计学意义(F组间分别为1.615、3.040和3.059,P均>0.05),但均较术前明显改善(F时间=7.567、5.639和255.498,P均<0.05),2组融合率均为100%。结论:腰椎间盘突出症翻修术中椎弓根螺钉内固定并单枚Cage加周围松质骨植入与双枚Cage植入的效果无显著差异。

Aim：To compare the efficacy of revision surgery for lumbar intervertebral disc herniation with one or two Cages.Methods：A total of 15 patients received the revision surgery for lumbar intervertebral disc herniation were collected,among whom,7 were treated with pedicle screws fixation and one Cage insertion with spongy bone transplant around the intervertebral space and 8 were treated with two Cages insertion in intervertebral space based on the vertebral diameter.They were followed up for 6 months to 2 years.Before operation,3 d and 24 weeks after operation,lumbar intervertebral space height,lumbar fusion rate and the JOA evaluation were observed.Results：There were no statistical differences in the intervertebral space height of L4/L5,L5/S1,and the JOA evaluation between the two groups（Fgroup=1.165,3.040 and 3.059,P0.05）,but they were improved after operation compared with preoperation in the both groups（Ftime=7.567,5.639,255.498,P0.001）.Fusion rates of the two groups were 100%.Conclusion：Pedicle screws fixation and one Cage insertion with spongy bone transplant around the intervertebral space has the similar efficacy to two Cages insertion in the intervertebral space during the revision surgery for lumbar intervertebral disc herniation.