新型解剖型纳米笼架在腰椎前路椎间融合中的应用

发布时间：2018-11-06 09:52

【摘要】：[目的]探讨解剖型纳米羟基磷灰石/聚酰胺66椎间融合器腰椎前路椎间融合术治疗腰椎退行性疾病的初步临床疗效。[方法]2014年2月~2016年2月本院收治23例腰椎退行性疾病患者,采用解剖型纳米羟基磷灰石/聚酰胺66椎间融合器斜向腰椎前路椎间融合术治疗。其中男10例,女13例;年龄51~64岁,平均54.20岁。腰椎间盘突出症13例,退变性腰椎滑脱7例,峡部裂性腰椎滑脱3例;观察手术时间、术中出血量及并发症发生情况,影像学观察椎间隙高度及植骨融合情况,以视觉疼痛模拟评分(VAS)和JOA评分评估临床效果。[结果]23例手术时间40~190 min,平均90 min;术中出血量30~120 ml,平均50 ml;全部病例随访8~26个月,平均18个月。随访期间1例发生术后屈髋和腰大肌无力,予以营养神经等保守治疗3周后症状缓解。余无内固定等相关并发症发生。椎间隙高度由术前平均(5.94±1.25)mm改善至末次随访的(9.58±1.27)mm。术后6个月时椎间植骨融合率91.70%,术前及末次随访腰痛VAS评分分别为(7.21±1.17)分、(0.73±0.69)分,腿痛VAS评分分别为(7.32±1.29)分、(0.79±0.58)分,JOA评分分别为(14.12±2.11)分、(27.42±1.32)分。[结论]解剖型纳米羟基磷灰石/聚酰胺66椎间融合器腰椎前路椎间融合术治疗腰椎退行性疾病初步临床应用疗效满意且并发症发生率低,可以作为腰椎退行性疾病的治疗方式之一。
[Abstract]:[objective] to investigate the preliminary clinical effect of anatomic nano-hydroxyapatite / polyamide 66 interbody fusion cage for anterior lumbar interbody fusion in the treatment of lumbar degenerative diseases. [methods] from February 2014 to February 2016, 23 cases of lumbar degenerative diseases were treated with anatomic nano-hydroxyapatite / polyamide 66 interbody fusion cage oblique anterior lumbar interbody fusion. Among them, 10 cases were males and 13 cases were females, the mean age was 54.20 years (51 ~ 64 years). 13 cases of lumbar disc herniation, 7 cases of degenerative lumbar spondylolisthesis, 3 cases of isthmic spondylolisthesis; The time of operation, the amount of intraoperative bleeding and the occurrence of complications, the height of intervertebral space and the fusion of bone graft were observed. The clinical effect was evaluated by visual pain analogue score (VAS) and JOA score. [results] the mean intraoperative blood loss was 30 ~ 120 ml, / 50 ml; for 40 ~ 190 min, and an average of 50 ml; in 23 cases. The mean follow-up time was 18 months (8 ~ 26 months). During the follow-up period, one patient developed postoperative flexor hip and psoas major weakness, and the symptoms were relieved after 3 weeks of conservative treatment. There were no related complications such as internal fixation. The height of intervertebral space improved from (5.94 卤1.25) mm to (9.58 卤1.27) mm. in the last follow-up. At 6 months after operation, the fusion rate of intervertebral bone graft was 91.70. The VAS scores of lumbar pain were (7.21 卤1.17), (0.73 卤0.69), (7.32 卤1.29) and (0.79 卤0.58), respectively, and those of leg pain were (7.32 卤1.29) and (0.79 卤0.58), respectively. The JOA scores were (14.12 卤2.11) and (27.42 卤1.32), respectively. [conclusion] Anatomical nano-hydroxyapatite / polyamide 66 interbody fusion cage for anterior lumbar interbody fusion has a satisfactory clinical effect and low incidence of complications in the treatment of lumbar degenerative diseases. It can be used as one of the treatments for lumbar degenerative diseases.
【作者单位】：南华大学附属第一医院脊柱外科;
【分类号】：R687.3

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