老年腰椎间盘突出症患者单纯椎间植骨融合与金属椎间融合器植入的远期疗效比较

Comparison of the Long-term Efficacy of Simple Interbody Fusion vs .Metal Interbody Fusion in Elderly Patients with Lumbar Intervertebral Disc Protrusion

目的 比较金属椎间融合器（Cage）植入术与椎间植骨融合术在老年腰椎间盘突出症患者术后椎间稳定性的临床效果。方法 28例腰椎间盘突出老年患者在椎间盘摘除后，15例19个椎间隙采用Cage植入（A组）；13例17个椎间隙采用单纯椎间植骨融合术（B组）。随访比较术后1周、6个月、24个月各患者X线片及C T片，测量施术节段椎间高度变化，评估两种方法的椎间稳定性。结果 术后6个月A组在维持椎间隙高度方面强于B组；术后24个月A组较B组椎间隙高度低；B组2年后融合率（88．24％）大于A组（84．21％）；其差异均有统计学意义（ P ＜0．05）。结论 术后6个月之内Cage植入术对腰椎稳定性效果优于单纯椎间植骨融合术；但其的远期效果较差。

Objective] To compare clinical efficacy of metal interbody fusion and bone graft（Cage） vs .interbody fu‐sion and bone graft for postoperative intervertebral stability of elderly lumbar intervertebral disc protrusion .[Methods]A total of 28 elderly patients with lumbar intervertebral disc protrusion were chosen .After discectomy ,15 patients （19 discs） underwent Cage implementation（group A） ,while 13 patients（17 discs） underwent simple interbody fusion and bone graft（group B） .X‐ray film and CT slice result of patients 1 week ,6 and 24 months after operation were followed up and compared .The change of segmental intervertebral height was measured .The intervertebral stability between two methods was compared .[Results]The maintenance of intervertebral height in group A at 6 months after operation was better than that in group B ,but intervertebral height in group A at 24 months after operation was lower than that in group B .The fusion rate of group B after 2 years（88 .24% ） was higher than that in group A（84 .21% ） ,and there was signifi‐cant difference（ P〈0 .05） .[Conclusion] The lumbar stability of Cage implantation within 6 months after operation is better than simple interbody fusion and bone graft ,but long‐term efficacy is poorer .