椎间盘镜下椎间定量植骨放置B-Twin治疗腰椎退行性疾病的临床观察

The Clinical Study of Intervertebral Quantitative and Bone Graft and Placed B-Twin Under the Microendoscopic Discectomy System for Lumbar Degenerative Disease

目的探讨经后路椎间盘镜下椎间定量植骨并放置可膨胀式椎间融合器（B-Twin）治疗腰椎退行性疾病的临床疗效。方法49例患者，男31例，女18例；年龄32-68岁，平均50岁；均有椎间盘突出症或椎管狭窄的典型症状，其中L4／5椎间盘突出34例，15／S1椎间盘突出15例；均伴椎体不稳。病程0．5-10年，平均5年；应用后路椎间盘镜系统将2枚可膨胀的椎间融合器植入椎间隙内。结果本组49例患者中，术后4-8d下床活动，33例在术后3d内症状完全消失，16例手术后症状明显减轻，残留有轻度腰痛症状。根据JOA评分：本组随访2-24个月，平均7.8个月，疗效优33例，良16例，优良率100%。结论在选择合适适应证的前提下，后路椎间盘镜下B-Twin腰椎椎闻融合术具有损伤小、住院时间短、早期下床活动等优点。

Objective To investigate clinieal curative effec! of intervertebral quantitative and bone graft and placement of ex- pandable type intervertebral fusion device（ B-Twin） under Ihe posterior microendoseopic diseectomy system for lumbar degenerative disease. Method Forty-nine patients,31 males and 18 females, between the age of 32- 68 years old,on average of 50,had typical symptoms of inter- vertebral disc herniation or spinal canal stenosis,including LA/5 34 cases of＇ intervertebral disc herniation and LS/S1 15 eases. All cases had vertebral instability. Course 0.5 - 10 years,the average 5 years. Two pieces of expandable expandable type intervertebral fusion devices were implanted in vertebral clearance under the posterior intervertebral disc mirror system. Results All the postoperatives could get off bed anti started moving between 4d to 8d after the operation. Postoperative symptoms disappeared completely in 33 cases within 3d, and of the other 16 cases reduced obviously, except for mild back pain symptnms remained. According to JOA score：the followed up for 2 - 24 months, an average of＂ 7.8 mouths,optimal curative effect in 33 cases,＂ good＂ in 16 cases,the exeellent-gond rate was 100%. Conclusion Under the preeondi- lion of apprupriate indications, B-Twin lumbar intervertebral fusion under the posterior intervertebral disc mirror has the advantages of little in- jury,shorter hospitalization time and early next bed aetivities etc.