钉棒系统内固定并改良自体骨后路椎间融合修复腰椎退行性病变

Internal fixation by nail-stick system and posterior lumbar interbody fusion with modified autogeneous bone for lumbar degenerative disease

背景:改良自体骨融合术是松质骨与皮质骨的结合,将二者同时应用到腰椎融合术中,能起到互补的作用,在保证融合率的同时,又能减少椎间隙高度的过度丢失。目的:探讨钉棒系统内固定并改良自体骨后路椎间融合修复腰椎退行性疾病的疗效。方法:将需要进行内固定治疗的60例腰椎退行性病变患者按修改方式不同分为2组,每组30例。改良组采用钉棒系统内固定并改良自体骨后路椎间融合,对照组采用钉棒系统内固定并Cage后路椎间融合,在内固定后3,6,12个月随访,比较2组患者术后并发症、腰腿痛改善率、椎间隙高度及腰椎生理前凸角的差异。结果与结论:与内固定前相比,2组患者在生活质量及腰腿痛方面均有明显的改善,改良组的术后并发症更少,椎间隙高度及腰椎生理前凸角的保持方面2组差异无显著性意义。提示钉棒系统内固定并改良自体骨后路腰椎融合与钉棒系统内固定并Cage后路椎间融合疗效相近,但自体骨移植组术后并发症更少。

BACKGROUND： The modified autogeneous bone fusion refers to the combination of cancellous bone and cortical bone. Their combination plays a complementary role in lumbar spinal fusion. This can ensure the fusion rate and reduce the excessive loss of intervertebral height. OBJECTIVE： To study the curative effect of internal fixation by nail-stick system and posterior lumbar interbody fusion with modified autogeneous bone for lumbar degenerative disease. METHODS＇. According to different operation methods, 60 patients with lumbar degenerative disease were equally divided into modified group and control group. The modified group was treated with internal fixation by nail-stick system and posterior lumbar interbody fusion with modified autogeneous bone, while control group was treated with internal fixation by nail-stick system and Cage posterior lumbar interbody fusion. All patients were detected at 3, 6, 12 months of follow-ups. The postoperative complications, improvement rate of low back pain, intervertebral height and lumbar lordosis angle after operation were observed and compared in two groups. RESULTS AND CONCLUSION： All the patients have better life quality and significant improvement in low back pain after surgery, when compared to before surgery. Fewer postoperative complications happen to patients in the modified group. There is no significant difference in intervertebral height and lumbar lordosis angle between the two groups. Internal fixation by nail-stick system and posterior lumbar interbody fusion with modified autogeneous bone is similar to internal fixation by nail-stick system and Cage posterior lumbar interbody fusion, but modified autogeneous bone has less complication than Cage in a long-term follow-up.