椎间混合植骨对微创腰椎融合术后椎间融合率的影响

The effect of intervertebral mixed bone grafting on the interbody fusion rate after minimally invasive lumbar fusion

目的评价椎间混合植骨对微创腰椎融合术后椎间融合率的影响。方法回顾性分析43例微创经椎间孔腰椎间融合术(MIS-TLIF)术后患者的临床资料,依据治疗方法不同分为治疗组(22例)与对照组(21例)。治疗组采用混合骨植骨治疗,对照组采用自体骨植骨治疗。比较两组视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)、改良型Brantigan评分及椎间融合率。结果术后第9、12个月,两组VAS评分均低于本组术前,且治疗组VAS评分分别为(3.45±0.39)、(2.67±0.46)分,低于对照组的(3.67±0.15)、(2.92±0.30)分,差异均有统计学意义(P<0.05)。术后第12个月,治疗组ODI为(21.53±3.25)%低于对照组的(23.45±2.19)%,差异有统计学意义(P<0.05)。术后第9、12个月两组ODI均低于本组术前,差异有统计学意义(P<0.05)。两组术后椎间融合率比较,差异无统计学意义(P>0.05)。结论椎间混合植骨可有效解决微创腰椎融合术自体骨量不足的问题,是解决微创腰椎融合术自体骨量不足和减少手术创伤的安全、可行手段之一。

Objective To evaluate the effect of intervertebral mixed bone grafting on the interbody fusion rate after minimally invasive lumbar fusion.Methods A total of 43 patients after minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)were divided into treatment group(22 cases)and control group(21 cases)according to different treatment methods.The treatment group was treated with mixed bone grafting,and the control group was treated with autologous bone grafting.The visual analogue scale(VAS)score,Oswestry dysfunction index(ODI)score,modified Brantigan score and interbody fusion rate were compared between the two groups.Results At 9 and 12 months after operation,the VAS scores of the two groups were lower than those before operation,and the treatment group[(3.45±0.39)and(2.67±0.46)points]was lower than the control group[(3.67±0.15)and(2.92±0.30)points].All the difference was statistically significant(P<0.05).At 12 months after operation,the ODI(21.53±3.25)% of the treatment group was lower than(23.45±2.19)% of the control group,and the difference was statistically significant(P<0.05).At 9 and 12 months after operation,the ODI of the two groups were lower than those before operation,and the difference was statistically significant(P<0.05).There was no statistically significant difference in interbody fusion rate between the two groups(P>0.05).Conclusion Intervertebral mixed bone grafting can effectively solve the problem of insufficient autogenous bone in minimally invasive lumbar fusion,and is one of the safe and feasible methods to solve the insufficient autogenous bone in minimally invasive lumbar fusion and reduce surgical trauma.