单侧椎弓根螺钉固定结合Cage植骨融合术对融合节段对侧小关节突的影响

发布时间：2018-03-20 03:36

本文选题：单侧固定　切入点：Cage植骨融合　出处：《南华大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的探讨单侧椎弓根螺钉固定结合椎间Cage植骨融合术对融合节段对侧小关节突形态的影响。方法通过收集我院脊柱外科2012年12月至2013年12月收治的L4/L5节段已行腰椎后路单侧椎弓根螺钉固定结合单枚Cage椎间融合手术的腰椎退行性疾病30例患者资料进行回顾性分析。调出患者术前及术后CT数据,利用CT测量软件平行于L5椎体上终板层面测量L4/L5节段手术对侧小关节角的大小以及小关节突横径距离,所采集数据利用统计学软件进行分析,同时采用日本矫形外科学会所采用(JOA)应用评分和VAS疼痛视觉模拟评分法评价术后患者腰骶部疼痛较术前有无明显减轻及术后疗效。结果1.小关节角度在术前为(42.61±5.75)度,术后为(42.85±5.394)度,P0.05,无统计学意义,故认为小关节角度在术前和术后没有明显变化。2.小关节横径在术前为(15.60±1.01)mm,术后为(15.89±1.48)mm,P0.05,无统计学意义。故认为小关节横径在术前和术后没有明显变化。3.VAS视觉模拟评分结果:术前VAS评分为(5.26±1.02),术后1周、6个月、12个月的VAS评分依次为(1.85±0.26)、(1.6±0.23)、(0.85±0.08),术后VAS评分明显低于术前,P0.05,具有统计学意义。术后腰骶部疼痛较术前明显缓解。4.由JOA评分结果可知,所有患者术前JOA评分为(10.47±1.36),术后1周、6个月、12个月的JOA评分依次为(21.77±1.55)、(23.58±1.58)、(23.64±1.80),术后患者JOA评分结果明显高于术前评分,P0.05,具有统计学意义。结论1、单侧椎弓根螺钉固定结合Cage椎间融合术对融合节段对侧小关节面角及小关节横径无明显影响。2、单侧椎弓根螺钉固定结合Cage椎间融合术对小关节形态的改变与腰骶部疼痛无明显的关系。3、单侧椎弓根螺钉固定结合单枚Cage椎间融合术是临床上治疗退行性腰椎病变中较经济且疗效确切的一种手术方式。
[Abstract]:Objective to investigate the effect of unilateral pedicle screw fixation combined with intervertebral Cage bone grafting and fusion on the morphology of the facet facet process in the contralateral facet of fusion. Methods L4 / L5 segment of spinal surgery admitted to our hospital from December 2012 to December 2013 was collected from December 2012 to December 2013. The data of 30 patients with lumbar degenerative diseases treated by posterior unilateral pedicle screw fixation and single Cage fusion surgery were retrospectively analyzed. The lateral facet angle of L4 / L5 segment was measured by using CT measurement software parallel to the upper end plate of L5 vertebrae, and the distance of facet facet transverse diameter was measured. The collected data were analyzed by statistical software. At the same time, the Japanese Orthopedic Surgical Association (JOAA) score and VAS pain visual analogue score were used to evaluate the postoperative lumbosacral pain and the postoperative curative effect. Results 1. The facet joint angle was 42.61 卤5.75 degrees before operation. The postoperative value was 42.85 卤5.394 degrees (P 0.05), no significant difference was found between the two groups. It is concluded that the facet joint angle does not change significantly before and after operation. The transverse diameter of facet joint is 15.60 卤1.01 mm before operation and 15.89 卤1.48 mm / mm after operation (P 0.05). It is considered that the transverse diameter of facet joint does not change significantly before and after operation .3.VAS visual analogue score (VAS). Results: the preoperative VAS score was 5.26 卤1.02g, and the VAS score of 1 week, 6 months and 12 months postoperatively was 1.85 卤0.26 and 0.85 卤0.08, respectively. The postoperative VAS score was significantly lower than that before operation (P 0.05), and the postoperative lumbosacral pain was significantly relieved than that before operation. The preoperative JOA score of all patients was 10.47 卤1.36, and the JOA scores of 1 week, 6 months and 12 months after operation were 21.77 卤1.55 and 23.64 卤1.80, respectively. The JOA score of all patients after operation was significantly higher than that of preoperative score (P 0.05). Conclusion 1. Unilateral pedicle screw fixation combined with Cage is significantly higher than that of preoperative score (P < 0.05). Intervertebral fusion had no significant effect on facet angle and transverse diameter of facet joint, and unilateral pedicle screw fixation combined with Cage intervertebral fusion had no significant relationship with lumbosacral pain. Pedicle screw fixation combined with single Cage interbody fusion is an economical and effective method for the treatment of degenerative lumbar disease.
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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