自锁稳定型椎间融合器前路融合术治疗退变性腰椎疾病的效果观察

Anterior lumbar interbody fusion with stable-type self-locking plate cage benezech for the treatment of degenerative lumbar diseases

目的探讨自锁稳定型椎间融合器前路融合术治疗退变性腰椎疾病的效果。方法选取2012年6月～2014年10月在我院就诊并治疗的单节段腰椎滑脱患者共46例。随机分为两组，各23例，分别进行经腹直肌旁小切口腹膜外间隙入路后自锁稳定型椎间融合器治疗术（ALIF）和传统的腰椎后路椎间融合术（PLIF）。记录患者术前、术后的症状和体征、术后的并发症及术后定期复查并评价植骨融合情况。采用日本骨科学会下腰痛评分系统（JOA评分）进行统计分析。结果ALIF组在术后JOA改善率为85．79％，并发症发生率为13．04％，均优于PLIF组。两组术后JOA评分比较，差异有统计学意义（P〈0．01）。结论在治疗腰椎退变性疾病时ALIF具有创伤小、术后临床效果好．患者恢复较快，并发症及后遗症少等优点，避免了腰椎后方结构的破坏，是一种新的微创外科手术方式。

Objective To investigate the effectiveness of application of ALIF （Anterior Lumbar Interbody Fusion） with stable-type self-locking PCB （Plate Cage Benezech） in treatment of degenerative lumbar diseases. Methods A total of 46 patients with lumbar spondylolisthesis treated in our hospital from June 2012 to October 2014 were selected and randomly divided into two groups,with 23 cases in each group.And the two groups were treated with lateral rectus small incision,ALIF with stable-type self-locking PCB after extraperitoneal space approach and conventional PLIF （Posterior Lumbar Interbody Fusion） respectively.Pre-operative and post-operative symptoms and signs and post-operative com- plications were recorded;the post-operative bone graft fusion was reviewed and evaluated.The JOA （Japanese Orthopaedic Association） scoring system was adopted for statistical analysis.Results The improvement rate of JOA and the incidence rate of complications in ALIF group was 85.79% and 13.04% respectively,which was better than those of PLIF group.The post-operative JOA scores between the two groups were statistically significant （P〈0.01）.Conclusion As a new minimally invasive surgical procedure,ALIF demonstrates its advantages of little trauma,excellent post-opera- tive clinical effects,faster recovery,less complications and sequelaes in the treatment of lumbar degenerative diseases, and avoids the destruction of the posterior structure of the lumbar spine.