不同轨迹螺钉组合固定能否加速椎间融合:临床前瞻性初步研究

Whether different trajectory screw combinations accelerate interbody fusion:a prospective clinical pilot study

目的将螺钉轨迹组合与传统椎弓根螺钉、传统皮质骨轨迹螺钉进行临床研究分析比较,以确定不同轨迹螺钉组合对于椎间应力和融合率的作用。方法根据螺钉轨迹不同组合分为传统皮质骨轨迹螺钉和新轨迹组合螺钉两组进行术中和术后的资料收集。结果术后随访中新组合的矫正程度显著超过传统皮质骨轨迹螺钉,而在术后随访症状评分、螺钉松动、螺钉突破皮质差异无统计学意义(P>0.05)。在融合率方面,新组合的术后椎间融合评分达到2分的比率比传统皮质骨轨迹螺钉增加了14%。在腰椎前凸矫正方面,新轨迹螺钉组合显著大于传统皮质骨轨迹螺钉。结论新轨迹螺钉组合螺钉内固定融合率较传统皮质骨轨迹螺钉更高,并能提供更大的腰椎前凸矫正,具有一定的临床使用前景。

Objective To compared these screw locus combinations with traditional pedicle screws and traditional cortical locus screws by clinical analysis to determine the effects of different locus screw combinations on intervertebral stress and fusion rate.Methods In this study,according to different combinations of screw trajectories,we were divided into two groups:traditional cortical bone locus screw and new cortical bone locus combined screw for intraoperative and postoperative data collection.Results In postoperative follow-up,the degree of correction of the new combination was significantly higher than that of the traditional cortical locus screw,but there was no significant difference in symptom score,screw loosening and screw breakthrough during postoperative follow-up.In terms of fusion rate,the ratio of postoperative interbody fusion score of 2 was 14%higher with the new combination than with the traditional cortical locus screw.The new locus screw combination was significantly superior to the traditional cortical locus screw in the correction of lumbar lordosis.Conclusion The fusion rate of the new combination is higher than traditional trajectory of cortical bone screws,and can provide greater lumbar lordosis correction,have certain prospect of clinical use.