Cage与植骨联合椎弓根螺钉内固定治疗腰椎滑脱的远期疗效比较

Comparison of long-term effects between Cage combined with pedicle screw fixation and bone grafting combined with pedicle screw fixation in treatment of patients with lumbar spondylolisthesis

目的对比Cage和植骨与椎弓根螺钉内固定联合治疗腰椎滑脱的远期临床效果。方法 94例腰椎滑脱患者随机分为观察组(n=47)与对照组(n=47),观察组给予植骨联合椎弓根螺钉内固定治疗,对照组给予Cage融合联合椎弓根螺钉内固定治疗,对比2组患者远期临床效果。结果观察组手术时间显著短于对照组(P<0.01),术中出血量显著少于对照组(P<0.01);2组JOA评分治疗后均显著增高(P<0.01),且术后观察组显著高于对照组(P<0.01),观察组术后恢复率显著高于对照组(P<0.01);2组术后复位率、椎间隙高度、术后1年椎间隙高度丢失均无显著差异(P>0.05),观察组术后植骨融合率则显著高于对照组(P<0.01);观察组手术并发症发生率显著低于对照组(P<0.01)。结论植骨联合椎弓根螺钉内固定术手术时间短,术中出血少,滑脱椎体恢复率高,椎间融合率高,且并发症较少,疗效确切,安全可靠,值得推广。

Objective To compare the long - term effects of Cage combined with pedicle screw fixation and bone grafting combined with pedicle screw fixation in treatment of patients with lumbar spondylolisthesis. Methods 94 patients with lumbar spondylolisthesis were divided into the observation group（ n = 47） and the control group（ n = 47）, the observation group was treated with bone grafting combined with pedicle screw fixation, and the control group was treated with Cage combined with pedicle screw fixation. Long - term effect was compared between the two groups. Results The operative time in the observation group was significantly shorter and blood loss was significantly less than the control group（P 〈 0.01 ）. JOA score in both groups increased significantly after the treatment （P 〈 0.01）, and of that in the observation group was significantly higher than the control group after the treatment （P 〈 0.01 ）. The recovery rate of the observation group was significantly higher than the control group（P 〈 0.01 ）. There were no significant differences of postoperative reduction rates, intervertebral height and intervertebral height 1 year after the operation between the two groups（P 〉0.05）, but fusion rate of grafted bone in the observation group was significantly higher than the control group（P〈 0.01）, and the incidence rate of complications in the observation group was significantly lower than the control group（P 〈 0.05）. Conclusion Bone grafting combined with pedicle screw fixation can shorten the operation time, reduce blood loss and improve the spondylolisthesis recovery rates and fusion rate of grafted bone, and it has fewer complications in patients with lumbar spondylolisthesis, so it is worthy of popularization.