改良自体骨并单Cage后路椎体间融合治疗腰椎退行性变的临床疗效研究

Clinical Study of Modified Autologous Bone and Single Cage Posterior Interbody Fusion in the Treatment of Lumbar Degenerative Diseases

目的：评价我院研究改良的椎间融合术的临床疗效。方法：2014年1月～2015年12月我科采用钉棒系统内固定联合自体骨并单Cage后路椎间融合术和钉棒系统内固定联合平行双Cage后路椎间融合术进行手术治疗60例单纯腰椎退行性变患者。按先后次序，将第1位需要手术的患者编入A组（采用钉棒系统内固定联合自体骨并单Cage后路椎间融合术进行治疗），第2例则为B组（采用钉棒系统内固定联合平行双Cage后路椎间融合术进行治疗），第3例A组，第4例B组，依此类推，各30例，共60例。比较2组患者手术时间、术中出血量及术后住院时间等指标，并对患者术后椎间隙高度、脊柱Cobb进行随访记录，评价2种手术的疗效。结果：2组资料术中出血量、术后椎间隙高度、术后住院时间及JOA评分术后恢复优良率比较无显著差异，手术时间差别有统计学意义。结论：改良自体骨并单Cage后路椎间融合与双枚Cage腰椎间融合联合椎弓根螺钉内固定术治疗腰椎退行性变，前者手术用时较后者少，两者临床疗效相似。

Objective： Evaluation of our hospital to improve the clinical efficacy of intervertebral fusion. Methods： From January 2014 to December 2015, we treated 60 patients with simple lumbar degeneration by Internal fixation combined with autologous bone and single cage posterior interbody fusion and Intemal fixation combined with parallel double cage posterior interbody fusion~ According to the order before and after, put the first patients who need surgery into the A group （ using the screw system with internal fixation combined with an- tologous bone and single Cage posterior lumbar interbody fusion treatment）, put the second case into the B group （using the stick System internal fixation combined with parallel double Cage posterior interbody fusion for treatment）, put the third patients into group A, the fourth patients into group B, and so on, the 30 cases, a total of 60 cases. The operative time, intraoperative blood loss and postoperative hospital stay were compared between the two groups. The height of the intervertebral space and the Cobb angle of the spine were recorded and evaluate the efficacy of the two operations. Results： There was no significant difference in the intraoperative blood loss, postoperative intervertebral space height, postoperative hospital stay and JOA score （RIS） in the two groups, The difference in operative time was statisti- cally significant. Conclusion：Improved autologous bone and single cage posterior interbody fusion takes less time than the double cage lumbar interbody combined with pedicle screw fixation, but the effect is similar.