椎间融合器植骨融合结合椎弓根螺钉内固定治疗腰椎管狭窄的临床效果

Clinical effect of interbody fusion and pedicle screw fixation in the treatment of lumbar spinal stenosis

目的观察椎间融合器植骨融合结合椎弓根螺钉内固定治疗腰椎管狭窄的临床疗效。方法回顾性分析2017年6月至2019年6月徐州仁慈医院收治的60例腰椎管狭窄患者的病例资料,根据治疗方法将患者分为对照组和观察组,每组各30例。对照组患者行常规椎管减压术治疗,观察组患者行椎间融合器植骨融合结合椎弓根螺钉内固定治疗。对比两组患者的手术相关指标、疼痛视觉模拟评分(VAS)、腰椎功能评分(ODI),随访患者的术后并发症情况。结果观察组患者的手术时间、下床活动时间及住院时间分别为(75.63±14.72) min、(2.15±0.32) d、(8.79±1.52)d,均短于对照组,术中出血量为(256.94±32.69) ml,少于对照组,差异均具有统计学意义(P <0.05);术前,两组患者的VAS评分、ODI评分比较,差异无统计学意义;术后,观察组患者的VAS评分、ODI评分分别为(2.04±0.46)分、(24.69±3.16)分,与对照组比较,差异具有统计学意义(P <0.05);3个月后随访患者的并发症发生情况,结果显示,观察组和对照组并发症发生率分别为6.7%、30.0%,差异具有统计学意义(P <0.05)。结论针对腰椎管狭窄患者行椎间融合器植骨融合结合椎弓根螺钉内固定治疗,创伤小、并发症少,有利于患者腰椎功能恢复,值得临床借鉴。

Objective To observe the clinical effect of interbody fusion and pedicle screw fixation in the treatment of lumbar spinal stenosis.Methods The clinical data of 60 patients with lumbar spinal stenosis admitted to Xuzhou Renci Hospital from June 2017 to June 2019 were analyzed retrospectively.According to the treatment method,the patients were divided into control group and observation group,with 30 cases in each group.The patients in the observation group were treated with routine laminoplasty and patients in the control group were treated with interbody fusion and pedicle screw fixation.The operation-related indexes,Visual Analogue Scale (VAS) score,Oswestry Disability Index (ODI)score of the two groups were compared,and the postoperative complications of patients were followed up.Results The operation time,ambulation time and hospitalization time of the patients in the observation group were (75.63±14.72) min,(2.15±0.32) d,(8.79±1.52) d,respectively,which were shorter than those in the control group.The intraoperative bleeding volume in the observation group was (256.94±32.69) ml,which was less than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in the VAS score and ODI score between the two groups before surgery.After surgery,the VAS score and ODI score of the observation group were (2.04±0.46) points and (24.69±3.16) points,respectively.Compared with the control group,the differences were statistically significant (P<0.05).The follow-up of the patients after 3 months showed that the complication rates in the observation and the control group were 6.7% and 30.0%,the difference was statistically significant (P<0.05).Conclusion For the patients with lumbar spinal stenosis,the treatment of interbody fusion combined with pedicle screw fixation is less traumatic and has fewer complications.It is beneficial to recovery of the patient’s lumbar function and worthy of clinical application.