椎弓根钉棒系统联合单纯自体颗粒骨椎间打压植骨治疗退变性腰椎管狭窄症的疗效分析

Therapeutic Effect of Pedicle Screw System Combined with Autogenous Granular Bone Interbody Compression and Bone Grafting on Degenerative Lumbar Spinal Stenosis

目的:分析椎弓根钉棒系统联合单纯自体颗粒骨椎间打压植骨治疗退变性腰椎管狭窄症的效果.方法:回顾性分析2013年1月-2016年6月笔者所在医院收治的退变性腰椎管狭窄症患者40例的临床资料,均进行椎弓根钉棒系统联合单纯自体颗粒骨椎间打压植骨治疗,观察围术期指标,比较术前及末次随访时的腰椎功能(JOA评分)、腰痛情况(VAS评分)、椎间隙高度.结果:本组患者均顺利完成手术,置钉过程中未损伤神经根及周围小动脉;融合一个节段的手术时间、术中出血量、术后引流量分别为(132.100±14.366)min、(185.950±58.601)mL、(249.240±66.731)mL,融合两个节段的手术时间、术中出血量、术后引流量分别为(215.370±16.770)min、(308.420±81.871)mL、(350.580±80.364)mL;末次随访时VAS评低于术前,JOA评分高于术前,差异均有统计学意义(P<0.001);术后、末次随访椎间隙高度均高于术前(P<0.001).结论:椎弓根钉棒系统联合单纯自体颗粒骨椎间打压植骨治疗退变性腰椎管狭窄症的椎间隙高度恢复可、腰椎功能恢复好,但远期疗效仍需进一步随访追踪.

Objective:To analyze the clinical efficacy of pedicle screw system combined with autogenous granular bone interbody compression and bone grafting in treatment of degenerative lumbar spinal stenosis. Method:The clinical data of 40 patients with degenerative lumbar spinal stenosis admitted to our hospital from January 2013 to June 2016 were analyzed retrospectively.All patients underwent pedicle screw system combined with autogenous granular bone interbody compression and bone grafting.Perioperative indicators were observed.The lumbar function(JOA score),low back pain(VAS score) and intervertebral space height before and at the last follow-up were compared.Result:The operation was successfully completed in all patients,and the nerve root and peripheral arterioles were not injured during the nailing process.The operation time,intraoperative bleeding volume and postoperative drainage volume of one fusion segment were(132.100±14.366)min,(185.950±58.601)mL,(249.240±66.731)mL respectively,the operation time,intraoperative bleeding volume and postoperative drainage volume of two fusion segments were(215.370±16.770)min,(308.420±81.871)mL,(350.580±80.364)mL respectively.At the last follow-up,the VAS score was lower than that of before operation, and the JOA score was higher than that of before operation,the differences were statistically significant(P<0.001). The height of intervertebral space after operation and at the last follow-up were higher than those of before operation(P<0.001).Conclusion:The pedicle screw system combined with autogenous granular bone interbody compression and bone grafting for degenerative lumbar spinal stenosis can restore the intervertebral space height and lumbar function,but the long-term effect still needs further follow-up.