自体骨移植在腰椎后路椎间融合术中的临床治疗研究

Clinical study of autologous bone transplantation in posterior lumbar interbody fusion

目的:研究腰椎后路椎间融合术治疗腰椎退变性疾病中使用自体椎板、棘突椎间植骨的临床效果。方法:2014年6月-2018年6月收治腰椎退变性疾病患者152例,根据术中使用的椎间植骨材料不同分为自体骨组50例、PEEK组53例、异体骨垫组49例,比较三组治疗效果。结果:三组手术时间、术中出血量、术后下床时间、住院时间及术后恢复率比较,差异无统计学意义(P>0.05)。三组术后JOA评分均明显高于术前,差异有统计学意义(P<0.05)。三组椎间隙高度比值及治疗位置椎节段恢复情况均优于术前,差异有统计学意义(P<0.05)。三组术后12个月椎间融合评级比较,差异无统计学意义(P>0.05)。结论:腰椎后路椎间融合术在治疗腰椎退变性疾病中使用自体椎板、棘突椎间植骨的治疗效果,能够达到PEEK融合器、异体骨融合器同样维持椎间隙高度的效果。

Objective:To study the clinical effect of autogenous lamina and spinous process intervertebral bone grafting in the treatment of lumbar degenerative diseases by posterior lumbar interbody fusion.Methods:From June 2014 to June 2018,152 patients with lumbar degenerative diseases were selected.According to the different intervertebral bone graft materials used during the operation,they were divided into the autogenous bone group with 50 cases,the PEEK group with 53 cases and the allogeneic bone pad group with 49 cases.We compared the treatment effects of the three groups.Results:There was no statistically significant difference in the operation time,intraoperative blood loss,postoperative bed time,hospital stay and postoperative recovery rate among the three groups(P>0.05).The JOA scores of the three groups after operation were significantly higher than those before operation,the difference was statistically significant(P<0.05).The ratio of the height of the intervertebral space in the three groups and the recovery of the vertebral segment at the treatment position were better than those before the operation,the difference was statistically significant(P<0.05).There was no statistically significant difference in the ratings of intervertebral fusion at 12 months after the operation of the three group(P>0.05).Conclusion:The effect of posterior lumbar interbody fusion in the treatment of lumbar degenerative diseases using autogenous lamina and spinous process intervertebral bone grafting can achieve the same effect of maintaining the height of the intervertebral space with PEEK fusion cage and allogeneic bone fusion cage.