椎间融合器加颗粒状自体骨椎间融合治疗腰椎滑脱症的疗效观察

Efficacy of interbody fusion cage and particulate autogenous bone interbody fusion for the treatment of lum-bar spondylolisthesis

目的探讨采用椎间融合器加颗粒状自体骨椎间融合法治疗腰椎滑脱症的临床疗效。方法选取腰椎滑脱症患者84例，根据随机数字表法分为两组，观察组采用椎间融合器加颗粒状自体骨椎间融合治疗，对照组使用植骨融合治疗，比较两种方法治疗后两组病例的术中情况、症状改观情况、融合率、影像学指示椎间隙变化等情况。结果观察组手术时间及手术出血量分别为（191．6±4．7）min，（670．8±14．5）ml，与对照组差异有统计学意义（t=3．99、7．39，均P〈0．01）。观察组共9例发生并发症，对照组共15例发生并发症，两组间并发症发生率差异有统计学意义（x2=5．37，P〈0．01）。两组椎间隙高度调查显示观察组对其改观明显（t=38．49，P〈0．01）。两组融合效果差异无统计学意义（t=2．49，P〉0．05）。结论采用椎问融合器加颗粒状自体骨椎问融合治疗腰椎滑脱症在手术安全性、术后并发症控制、椎间高度改善相比，观察组有其优越性，值得进一步推广研究。

Objective To explore the treatment efficacy of interbody fusion cage and particulate autogenous bone interbody fusion in the treatment of lumbar spondylolisthesis. Methods 84 patients with lumbar spondylolisthe- sis were randomly divided into two groups. The experimental group was given interbody fusion and granular autologous bone interbody fusion. The control group received fusion therapy. The symptoms improvment, fusion rate, imaging indi- cates intervertebral space changes of two groups were compared. Results The operation time and blood loss of the ex- perimental group were （191.6 ±4.7）min, （670.8 ± 14.5 ）ml, compared with the control group the differences were statistically significant（ t = 3.99,7.39, all P 〈 0.01 ）. There were 9 cases occurred complications in the experimental group, 15 eases in the control group,the incidence rate of complications between the two groups had statistical differ- ence （x2 =5.37 ,P 〈0. 01 ）. The disc space height survey showed that the experimental group was improved significantly（ t = 38.49 ,P 〈0. 01 ）. The fusion performance between the two groups had no significant difference（ t = 2.49, P 〉 0. 05 ）. Conclusion Interbody fusion cage and granular autologous bone interbody fusion in the treatment of lum- bar spondylolisthesis is safe, and can control the postoperative complications, improve intervertebral height, which is worthy of clinical application.