后路膨胀式椎弓根钉治疗骨质疏松性老年椎管狭窄

Surgical treatment of osteoporotic lumbar degenerative disease with posterior fixation of expandable pedicle screw

目的：探讨后路膨胀式椎弓根钉（ EPS）结合椎间融合治疗骨质疏松性老年腰椎管狭窄的疗效。方法采用后路EPS结合椎间融合治疗25例骨质疏松性老年腰椎管狭窄患者。采用JOA临床腰椎手术评分系统对手术效果进行评价，参考Burkus et al及Singh et al的方法评估椎弓根螺钉稳定性及脊柱融合情况。结果患者均得到随访，时间6~25个月。末次随访时JOA改善率：显效19例，有效4例，无效2例。螺钉稳定性评分平均为（2.9±177;0.3）分，骨融合评分平均为（2.8±177;0.2）分。未出现螺钉松动、拔出，滑脱无复发。结论采用EPS结合椎间融合可有效治疗骨质疏松性老年椎管狭窄，术后融合率高，并发症少。

Objective To evaluate the clinical effect of expandable pedicle screw （ EPS） system and intervertebral fu-sion in osteoporosis lumbar spinal stenosis. Methods 25 gerontal patients with lumbar spinal stenosis and severe os-teoporosis received EPS fixation and intervertebral fusion. The JOA lumbar spine surgery scoring system was used in the post-operative evaluation. The plain films were conducted to evaluate the spinal fusion rate and fixation effective-ness of the EPS according to the methods of Burkus et al and Singh et al. Results All patients were followed up for 6~25 months. At last follow-up, the improvement rate of JOA scores were 19 patients with obvious effect, 4 patients with effect and 2 with no effect. The score of screw stabilization was 2. 9 ±177; 0. 3. The fusion index was 2. 8 ±177; 0. 2. There was no loosening,breakage or pullout of the EPS. Conclusions The EPS fixation and intervertebral fusion can achieve excellent clinical effect in osteoporosis lumbar spinal stenosis with high spine fusion rate and low complica-tion.