双枚融合器行腰椎椎间融合术治疗腰椎退行性疾病的疗效

The efficacy of posterior lumbar interbody fusion with double-cage in the treatment of lumbar degenerative diseases

目的 探讨双枚融合器行腰椎椎间融合术(PLIF)治疗腰椎退行性疾病的疗效。方法 将60例腰椎退行性疾病患者根据PLIF术中置入融合器数量的不同分为双枚组(30例)和单枚组(30例)。比较两组疼痛VAS评分、ODI评分、椎间隙高度、腰椎局部前凸角、椎间融合及融合器沉降情况。结果 患者均获得随访,时间1~3年。末次随访时,两组腰痛及下肢痛VAS评分、ODI评分均较术前明显改善(P<0.05),但组间比较差异均无统计学意义(P>0.05)。椎间隙高度及腰椎局部前凸角:两组术后7 d、末次随访时较术前均明显改善(P<0.05);末次随访时,单枚组较术后7 d均有明显丢失(P<0.05),双枚组较术后7 d均无明显丢失(P>0.05),双枚组均显著优于单枚组(P<0.05)。末次随访时,椎间融合率单枚组低于双枚组(P<0.05),融合器沉降率单枚组高于双枚组(P<0.05)。结论 双枚融合器行PLIF治疗腰椎退行性疾病可降低术后融合器的沉降发生率,提高椎间融合率,良好维持术后椎间隙高度及腰椎局部前凸角。

Objective To investigate the efficacy of posterior lumbar interbody fusion(PLIF)with double-cage in the treatment of lumbar degenerative diseases.Methods Sixty patients with lumbar degenerative diseases were divided into double-cage groups(30 cases)and single-cage group(30 cases),according to the number of cage implants during PLIF.Pain VAS,ODI scores,intervertebral space height,lumbar local lordosis angle,interbody fusion and cage subsidence situation were compared between the two groups.Results All patients were followed up for 1~3 years.At the last follow-up,pain VAS for lumbago and lower extremity pain and ODI scores in both groups were significantly improved,compared with those before surgery(P<0.05),but there were no statistical differences between two groups(P>0.05).Intervertebral space height and lumbar local lordosis angle:at 7 d after surgery and the last follow-up,they were significantly increased in both groups than before surgery(P<0.05);at the last follow-up,the single-cage group had significant loss,compared with 7 d after surgery(P<0.05),no significant loss was observed in double-cage group,compared with 7 d after surgery(P>0.05),and double-cage group was significantly better than single-cage group(P<0.05).At the last follow-up,the interbody fusion rate was lower in the single-cage group than that in the double-cage group(P<0.05),the settlement rate of the single-cage group was higher than that of the double-cage group(P<0.05).Conclusions PLIF for treatment of lumbar degenerative diseases with double-cage can reduce the incidence rate of postoperative fusion device subsidence,improve the postoperative interbody fusion rate,and maintain the postoperative intervertebral height and local lumbar local lordosis angle well.