预防螺钉松动拔出及复位椎体再滑脱:如何更好的治疗骨质疏松性腰椎滑脱症
发布时间：2018-08-15 15:21
【摘要】：背景:研究认为膨胀式椎弓根螺钉抗旋能力强,可以很好的预防螺钉松动、拔出,维持腰椎稳定性、保持其生理曲度,为远期椎体间融合提供一个安全稳定的环境。目的:探讨膨胀式椎弓根螺钉与普通椎弓根螺钉治疗骨质疏松性腰椎滑脱症的差异。方法:合并骨质疏松的腰椎滑脱症患者共67例分为保守组12例、膨胀式椎弓根螺钉组20例、普通椎弓根螺钉组35例。3组采集入院时、入院后1周、出院后6个月、出院后12个月、出院后24个月的目测类比评分和JOA评分及影像学资料,对螺钉稳定性、脊柱融合情况进行评估,参考Meyerding滑脱分级标准评估椎体的滑脱情况。结果与结论:(1)末次随访时JOA改善率:膨胀式椎弓根螺钉组与普通椎弓根螺钉组相比较差异无显著性意义(P=1.00),均显著高于保守组(P均0.05);(2)目测类比评分:膨胀式椎弓根螺钉组与普通椎弓根螺钉组均显著降低,两组间比较差异无显著性意义(P0.05),而保守治疗组目测类比评分时高时低,反复变化;(3)滑脱复位率:膨胀式椎弓根螺钉组明显高于普通椎弓根螺钉组(P0.01);(4)内固定后24个月脊柱融合评分:膨胀式椎弓根螺钉组明显高于普通椎弓根螺钉组(P=0.035);(5)结果说明:对于合并骨质疏松的腰椎滑脱患者,采用膨胀式椎弓根螺钉固定在滑脱复位、植骨融合率、螺钉稳定性等方面都明显优于普通椎弓根螺钉,此方法更加安全有效。
[Abstract]:Background: it is considered that the expansion pedicle screw has strong anti-rotation ability, which can prevent screw loosening, pull out, maintain the stability of lumbar vertebrae, maintain its physiological curvature, and provide a safe and stable environment for long-term interbody fusion. Objective: to investigate the difference of the treatment of osteoporotic lumbar spondylolisthesis with expansion pedicle screw and common pedicle screw. Methods: 67 cases of lumbar spondylolisthesis complicated with osteoporosis were divided into conservative group (n = 12), expansion pedicle screw group (n = 20) and common pedicle screw group (n = 35). The visual analogue score, JOA score and imaging data were evaluated 12 months after discharge and 24 months after discharge. The screw stability and spinal fusion were evaluated. The spondylolisthesis was evaluated according to Meyerding criteria. Results and conclusion: (1) the improvement rate of JOA at the last follow-up: there was no significant difference between the expansion pedicle screw group and the common pedicle screw group (P0. 00), which were significantly higher than that in the conservative group (P0. 05); (2). Both the screw group and the common pedicle screw group were significantly lower than those in the common pedicle screw group. There was no significant difference between the two groups (P0.05), but the visual analogue score of conservative treatment group was higher than that of control group. (3) reduction rate of spondylolisthesis: the spinal fusion score of the expansion pedicle screw group was significantly higher than that of the common pedicle screw group (P0.01); (4) 24 months after internal fixation: the expansion pedicle screw group was significantly higher than the common pedicle screw group (P0. 035); (5). For lumbar spondylolisthesis with osteoporosis, Expansion pedicle screw fixation was superior to the common pedicle screw in slippage reduction, bone graft fusion rate and screw stability. This method was more safe and effective.
【作者单位】： 重庆医科大学附属永川医院骨科;
【基金】：重庆医科大学附属永川医院资助项目(YJLCX201540)~~
【分类号】：R580;R687.3
，
本文编号：2184611
[Abstract]:Background: it is considered that the expansion pedicle screw has strong anti-rotation ability, which can prevent screw loosening, pull out, maintain the stability of lumbar vertebrae, maintain its physiological curvature, and provide a safe and stable environment for long-term interbody fusion. Objective: to investigate the difference of the treatment of osteoporotic lumbar spondylolisthesis with expansion pedicle screw and common pedicle screw. Methods: 67 cases of lumbar spondylolisthesis complicated with osteoporosis were divided into conservative group (n = 12), expansion pedicle screw group (n = 20) and common pedicle screw group (n = 35). The visual analogue score, JOA score and imaging data were evaluated 12 months after discharge and 24 months after discharge. The screw stability and spinal fusion were evaluated. The spondylolisthesis was evaluated according to Meyerding criteria. Results and conclusion: (1) the improvement rate of JOA at the last follow-up: there was no significant difference between the expansion pedicle screw group and the common pedicle screw group (P0. 00), which were significantly higher than that in the conservative group (P0. 05); (2). Both the screw group and the common pedicle screw group were significantly lower than those in the common pedicle screw group. There was no significant difference between the two groups (P0.05), but the visual analogue score of conservative treatment group was higher than that of control group. (3) reduction rate of spondylolisthesis: the spinal fusion score of the expansion pedicle screw group was significantly higher than that of the common pedicle screw group (P0.01); (4) 24 months after internal fixation: the expansion pedicle screw group was significantly higher than the common pedicle screw group (P0. 035); (5). For lumbar spondylolisthesis with osteoporosis, Expansion pedicle screw fixation was superior to the common pedicle screw in slippage reduction, bone graft fusion rate and screw stability. This method was more safe and effective.
【作者单位】： 重庆医科大学附属永川医院骨科;
【基金】：重庆医科大学附属永川医院资助项目(YJLCX201540)~~
【分类号】：R580;R687.3
，
本文编号：2184611
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