摘要
目的:探讨椎间融合加椎弓根螺钉内固定治疗退变性腰椎不稳的临床疗效及其适应证。方法:自2001年5月-2004年1月,对37例退变性腰椎不稳同时合并有腰椎间盘突出症或腰椎管狭窄症患者,经系统非手术治疗3个月以上无效而行椎间融合加椎弓根螺钉内固定系统手术治疗。其中26例采用腰椎体间融合器(cage)椎间融合加TSRH椎弓根钉棒内固定系统,11例采用腰椎体间融合器椎间融合加TENOR-Ⅱ椎弓根钉棒内固定及复位系统。结果:术后均获得随访,随访时间3-30个月,平均12.2个月。根据腰椎不稳与腰椎管狭窄专题研讨会纪要所采用临床疗效评定标准:优26例,良10例,差1例,优良率达97％。根据下腰痛评分(JOA score)由术前平均6.9分提高到术后20.6分。随访期间椎体间固定融合节段稳定,融合良好,无椎间高度及复位丢失等其他并发症发生。结论:严格掌握手术适应证,临床症状、体征与影像学检查相符合的退变性腰椎不稳通过手术治疗可获得良好的临床疗效。
Objective:To investigate the clinical effect for the treatment of degenerative lumbar instability and to define the indication for surgical intervention. Methods:From May 2000 to January 2004,37 patients with degenerative lumbar instability were treated with transpedicular screw fixation combined with the posteri -or lumbar interbody fusion with cages. For the patients with lumbar disc protrusion or spinal canal stenosis, passing through non-operative treatment for 3 months were no effect. Among them,26 cases were treated using the posterior lumbar interbody fusion with cages combined with TSRH pedicle screw spinal system and 11 cases using the posterior lumbar interbody fusion with cages combined with pedicle screw spinal system TENOR-Ⅱ .Results:All the cases were followed up from 3 months to 30 months with an average of 12.2 months. According to standard of evaluation,the result was excellent in 26,good in 10,poor 1,the satisfactory rate was 97% .The JOA's lumbar pain scores reach to average from 6.9 to 20.6. In following-up period,solid fusion was satisfactory in all cases, there was no implants breakage and loosening. Conclusion: Indication of surgical fusion should be strictly limited to avoid over-treament. The surgical treatment of degenerative lumbar instability might achieve satisfactory clinical effects.
出处
《中国骨伤》
CAS
2004年第10期602-604,共3页
China Journal of Orthopaedics and Traumatology
