腰椎后外侧融合和BAK椎体间融合的疗效比较

A Comparison of Results of Posterolateral Fusion and BAK Interbody Fusion

目的 证明BAK椎体间融合优于后外侧融合。方法 腰椎滑脱 2 6例采用Steffee钢板和后外侧融合与腰椎滑脱 16例采用Silhouetle脊柱棒系统对腰椎滑脱复位固定和BAK椎间植骨融合器椎间植骨融合 ,比较它们的融合、复位和临床结果。结果 后外侧融合 2 6例随诊 6～ 36个月 ,临床融合率 80 8% (2 1/ 2 6 ) ,滑脱复位率 6 1% (16 / 2 6 ) ,临床疗效 :优 9例 ,良 9例 ,可 3例 ,差 5例 ,优良率 6 9%。BAK椎体间融合 16例患者随诊 6～ 2 0个月。临床融合率为 93 7% (15 / 16 ) ,滑脱复位率为87 5 % (14/ 16 ) ,临床疗效 :优 9例 ,良 5例 ,可 2例 ,优良率 90 %。结论 对腰椎滑脱的复位固定 ,Silhouetle脊柱棒系统较Steffee钢板有较多优点 ,与后外侧融合比较 ,BAK椎间融合器植入椎间隙后 ,椎体界面间固定 ,椎间隙无塌陷 ,无植骨吸收 ,能增大和维持椎间隙和椎间孔高度 ,间接扩大侧隐窝和恢复脊柱生理曲度 ,有较大的植骨床 ,有利于植骨融合 ,使患者早期下床。近期随访结果表明 ,Silhouetle脊柱棒系统固定和BAK椎间植骨融合器椎间植骨融合的临床疗效明显优于Steffee钢板固定和后外侧融合。

Objective To verify the advantages of BAK interbody fusion to the usual posterolateral fusion.Methods Twenty-six patients were treated with posterolateral fusion,and 16 were treated with BAK interbody fusion.They were compared for union,reduction of the deformity,and clinical results.Results The posterolateral fusion 26 patients were followed up for an average 26 months (range 6～36 months) after operation.The reduction of spondylolisthesis was 61%,the fusion rate 80.8%,and 69% of the patients obtained successful clinical outcome.The BAK interbody fusion 16 patients were followed up for an average 16 months(range 6～20 months) after operation.The reduction of spondylolisthesis was 87.5%,the fusion rate 93.7%,and 90% of the patients obtained successful clinical outcome.Conclusion Silhouetle spinalrod system may be reliable for the treatment of spondyldisthesis.Implantation of BAK interbody fusion system into the interbody space can stabilize the fused segments,prevent the collapse of interbody space,avoid bone resorption,remain or increase the heights of the interbody space,facilitate the union of the fused segments,and allow early mobilization.