保留终板颗粒骨椎间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

目的观察保留终板、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~2009年10月期间,因腰椎不稳症行保留终板、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23例病例。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大部分消失,术后JOA评分较术前明显提高﹙〈0.05﹚,Oswestry功能障碍指数较术前明显减少﹙〈0.05﹚。术后、最终随访较术前椎间隙高度明显增高﹙〈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,是一种有效的治疗方法。

Objective To evaluate the clinical efficacy ofpedicle screw fixation and posterior lumbar interbody fusion（ PLIF ） with Preserving Endplates and morselized impacted bone graft in treatment of lumbar instability. Methods Between April 2005 and October 2009, 23 patients with instability of lumbar were treated with this method. Observation of the clinical ef- ficacy, fusion rate mad interbody space height. Results The symptoms signs were released. Comparement about preoperative and postoperative JOA scores, Oswestry index and intervertebral height （ P〈0.05 7. Fusion rate was 95.7%. Excellent rate was 87.0%. Conclusion The method is an effective way of treating lumbar instability. This method is simple and cheap with advantages of less injury and high fusion rate.