丝线捆扎技术在腰椎后方韧带复合体损伤中的临床疗效

The clinical study of surgical suture stitching in the injury of lumbar posterior ligament complex

目的:提出一种简单经济的腰椎后方韧带复合体(PLC)损伤修复方法,评价丝线捆扎在PLC损伤中的临床疗效。方法:回顾性分析行后路腰椎椎间融合术并邻位椎体PLC断裂损伤的15例患者的临床资料,男9例,女6例,年龄平均59.8岁,采用疼痛视觉模拟评分(VAS)、日本骨科学会(JOA)评分、治疗改善率及MacNab分级评价临床疗效。结果:15例手术全部按术前计划完成,未因使用常规丝线额外增加手术费用,随访时间1~26个月。VAS评分由术前(6.5±1.06)分降至术后3个月(0.4±0.63)分。术后3个月JOA评分(25±2.04)分,治疗改善率79.8%,MacNab分级优良率92.9%。至随访日止,15例患者均未出现临近节段退变。结论:丝线捆扎技术修复腰椎后方韧带复合体简单有效,经济实惠,可减少临近节段退变的发生率。

Objective:To present a simple and economical method of repairing the injury of lumbar posterior ligament complex(PLC),and evaluate the clinical effect of surgical suture stitching in PLC injury.Methods:Altogether 15 patients with adjacent vertebral PLC injury,underwent posterior lumbar interbody fusion because of lumbar degenerative diseases were analyzed retrospectively.There were 9 males and 6 females with an average age of 59.8 years.The clinical efficacy was evaluated by visual analogue scale(VAS),Japanese orthopaedic association score(JOA),improvement rate and MacNab grading.Results:All the operations were completed according to the preoperation plan,and no additional cost was increased due to the use of conventional surgical suture.Patients were followed up from 1 to 26 months.Three months after operation,the VAS score decreased from(6.5±1.06)before operation to(0.4±0.63),the JOA score was(25±2.04),the improvement rate was 79.8%,and the fine rate of MacNab grading was 92.9%.Up to the follow-up date,no adjacent segment degeneration(ASD)occurred in 15 patients.Conclusions:Surgical suture stitching is a simple,effective and economical method for the repair of lumbar posterior ligament complex,and can also reduce the incidence of adjacent segment degeneration.