单侧钉棒固定椎间植骨融合治疗短节段退行性腰椎不稳定的效果观察

Study on clinical effect of unilateral intertrochanteric bone grafting in treatment of short segmental degenerative lumbar instability

目的：分析与研究单侧钉棒固定椎间植骨融合治疗短节段退行性腰椎不稳定临床效果.方法：随机选取2013年1月-2015年6月我院短节段退行性腰椎不稳定患者48例,采用单侧钉棒固定椎间植骨融合治疗,手术治疗前和末次随访时采用专业评分法评价患者的满意度,应用相应标准判断植骨融合率.结果：对所有患者进行手术后跟随采访6-18个月.48例患者手术平均时间为78±10分钟,手术中失血量为175.5±32.5ml,平均下床活动时间2.3±0.4天;末次跟随采访时满意度与术前相比,明显高于术前.手术术后患者的腰椎功能优良率为95.8%,植骨融合率为87.5%,植骨愈合时间5.8±3.3个月.无继发临近节段退变现象出现.结论：单侧钉棒固定椎间植骨融合治疗手术具有创伤小、术后恢复快、并发症发生率低等特点,是治疗腰椎退行性不稳定的有效方法之一,值得临床应用与推广.

Objective： To analyze and study the clinical effect of unilateral intertrochanteric bone grafting in the treatment of short segmental degenerative lumbar instability. Methods： Forty - eight patients with degenerative lumbar vertebrae instability in our hospital from January 2013 to June 2015 were randomly selected and treated with unilateral screw fixation for intervertebral fusion. Before and at the end of the follow - up. The fusion rate was evaluated by the corresponding criteria. Results： All patients were followed up for 6 to 18 months after surgery. The average time of operation was （78± 10） min, the blood loss during operation was （175.5 ± 32.5） ml and the average time of ambulation was （2.3± 0.4） d. The satisfaction of the last follow - Significantly higher than preoperative. The excellent rate of lumbar function was 95.8%, the fusion rate of bone graft was 87.5% and the time of graft healing was 5.8 ± 3.3 months. No second- ary proximal segment degeneration occurs. Conclusion： Unilateral fixation of interbody fusion screw fixation had the characteristics of small trauma, rapid postoperative recovery and low incidence of complications. It was one of the effective methods for the treatment of lum bar degenerative instability. It was worthy of clinical application and popularization.