下位节段椎间融合器融合、上位节段自体骨植骨融合治疗双节段退变性腰椎不稳临床观察

发布时间：2018-07-01 19:26

本文选题：退变性腰椎不稳 + 椎间融合　；参考：《山东医药》2017年16期

【摘要】：目的探讨下位节段椎间融合器融合、上位节段自体骨植骨融合治疗双节段退变性腰椎不稳的临床效果。方法选择双节段退变性腰椎不稳患者75例,其中35例采用下位节段椎间融合器融合、上位节段自体骨植骨融合联合后路内固定系统治疗(改良组),40例采用双节段椎间融合器融合联合后路内固定系统治疗(对照组)。比较两组术前及术后1、16个月日本骨科学会下腰痛功能评分(简称JOA评分)、疼痛视觉模拟评分(VAS),术前及术后16个月上、下邻近节段的椎间隙高度及椎间盘Pfirrmann评分。结果两组术后1、16个月JOA评分均高于术前,VAS均低于术前(P均0.05);两组术后1、16个月JOA评分及VAS比较差异均无统计学意义(P均0.05)。与术前比较,两组术后上邻近节段椎间隙高度均降低,但对照组降低更明显(P均0.05)。两组术后下邻近节段椎间隙高度及上、下邻近节段椎间盘Pfirrmann评分均较术前无明显改变,两组术后上述指标比较差异均无统计学意义(P均0.05)。结论下位节段椎间融合器融合、上位节段自体骨植骨融合治疗双节段退变性腰椎不稳的效果较好,并可减少上邻近节段退变。
[Abstract]:Objective to investigate the clinical effect of interbody fusion cage fusion in lower level and autologous bone graft fusion in superior segment in the treatment of double degenerative lumbar spine instability. Methods 75 patients with double degenerative lumbar vertebrae instability were selected, 35 of them were treated with lower level interbody fusion cage. 40 cases of superior segment autologous bone graft fusion combined with posterior internal fixation system (modified group) were treated with double segment fusion of interbody cage and posterior internal fixation system (control group). JOA score, visual analogue pain score (VAS), intervertebral space height and disc Pfirrmann score were compared between the two groups before and 1, 16 months after operation. Results the JOA scores at 1 and 16 months after operation in the two groups were higher than those before operation (P 0.05), but there was no significant difference in JOA scores and VAS between the two groups at 1,16 months after operation (P 0.05). The height of upper adjacent intervertebral space in the two groups was lower than that before operation, but that in the control group was more significant (P 0.05). The Pfirrmann scores of lower adjacent intervertebral space and upper and lower proximal intervertebral disc in the two groups were not significantly changed compared with those before operation, and there was no significant difference between the two groups in the above indexes (P 0.05). Conclusion the fusion of lower segmental fusion cage and superior segmental autologous bone graft fusion is effective in the treatment of double degenerative lumbar spine instability and can reduce the degeneration of upper adjacent segment.
【作者单位】：安徽医科大学第一附属医院;武汉大学人民医院;
【基金】：国家自然科学基金资助项目(81171797) 湖北省自然科学基金资助项目(2011CHB022)
【分类号】：R687.3

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