螺纹异体皮质骨椎间融合支架治疗下腰椎不稳的临床初步报告(英文)

Preliminary report on treating lumbar spondylolisthesis with allograft interbody fusion cage

目的 报告一种作者自行设计制作的螺纹异体皮质骨椎间融合支架 (allograftinterbodyfusioncage ,AIFC)椎间融合治疗下腰椎不稳的临床初步疗效。 方法 本组共 2 7例 ,其中男 12例 ,女 15例 ,年龄 2 0～ 72岁 ,平均 4 8.5岁。Ⅰ°～Ⅱ°滑脱 17例 ,Ⅱ°～Ⅲ°滑脱 7例 ,退行性腰椎不稳 3例。前路手术 3例 ,后路手术 2 4例 ,其中 15例同时行Steffee钢板和RF或FJ内固定 ,手术共植入AIFC39个 ,其中一个间隙植入 2个 9例 ,植入 1个 15例 ,同时 2个间隙各植入 1个 3例。结果 平均随访 13个月 ,临床疗效评价 :优 2 1例 ,良 5例 ,可 1例。X线动态观察 :术后 3～ 4月手术撑开的椎间隙有 1～ 2mm的回落丢失 ,1例AIFC破裂 ,全部获骨性愈合。结论 AIFC具有足够支撑、维护椎间隙高度功能 ,抗滑稳定性好 ,椎间融合率高 ,可避免取髂骨和金属椎间融合器记永久植入的一些并发症 ,不失为一种较理想的治疗下腰椎失稳症的方法。

Objective:To report a newly designed allograft interbody fusion cage (AIFC) for treating lumbar spodylolisthesis.Methods:27 cases of lower lumbar spondylolisthesis and degenerative lumbar instability patients were treated with 39 AIFCs, one space implanted two AIFC in 9 intervertebral spaces and one AIFC in 21 intervertebral spaces. 3 cases of them were anterior lateral approach and the other 24 cases were posterior lateral approach.15 cases were treated simultaneously by internal fixation with Steffee and RF or FJ. Among them 12 were male and 15 female, with age from 20 to 72 years (average 48.5 years). Preoperative radiography suggested Ⅰ°～Ⅱ° and Ⅱ°～Ⅲ° degrees of spondylolisthesis were in 17 and 7 cases respectively, and 3 cases were degenerative lumber instability.Results:At an average of 13 months, fellow-up for AIFC, 21 patients had excellent results, 5 good and 1 fair in clinical evaluation. All segments were confirmed to be solidly fused by constant X-ray examination and there was 1～2 mm loss in height of supported interspace at 3～4 months after operation. Break of AIFC was observed in one of them. There were no angular deformities and severe neurologic complication.Conclusions:AIFC could provide enough support, anti-slide ability and could remain or increase the height of intervertebral space. The fusion rate was similar to that of autograft. Some complications caused by implanting auto lilac crest and metal cage can be Received date:Jan.20,2003 avoided. The authors thought it was an ideal fusion method for treating lumbar spondylolisthesis.