摘要
目的:对老年腰椎狭窄症患者实施椎弓根螺钉内固定术+腰椎后侧植骨融合术治疗,分析治疗后的效果。方法:从北京丰台医院骨科收入的老年腰椎管狭窄症患者中选择此该项目的研究对象,入选研究对象的入院时间在2020.01月至2021.12月,入选例数总共有80例,将入选研究对象按照手术治疗方案进行分组,其中开展椎弓根螺钉内固定术+椎间植骨融合术治疗的40例患者纳入对照组,余下40例展开椎弓根螺钉内固定术+后外侧植骨融合术治疗的患者纳入观察组。比较两组在植骨融合率、手术治疗情况、疼痛程度及炎症因子水平方面的情况,统计并发症发生情况,观察腰椎功能及生活质量。结果:在植骨融合率上,两组对比无显著差异(P>0.05)。同对照组相比,观察组在手术时长与住院天数方面的耗时更短,术中出血量更少(P<0.05)。在VAS评分、C反应蛋白(CRP)及白细胞介素-6(IL-6)方面,观察组同对照组相比明显更低(P<0.05)。相较于对照组,观察组的并发症发生率及ODI评分明显更低,腰椎活动度、JOA评分显著更高(P<0.05)。在生理、环境、心理及社会关系评分方面,观察组高于对照组(P<0.05)。结论:针对老年腰椎管狭窄症患者,实施椎弓根螺钉内固定术+后外侧植骨融合术治疗的效果显著,可有效提高植骨融合率,优化手术情况,减轻疼痛程度及炎症损伤,减少术后并发症的发生,增加腰椎活动度,推动腰椎功能的康复,临床可进一步推广应用。
Objective Treatment of elderly patients with lumbar spinal stenosis with pedicle screw internal fixation+posterior lumbar implant fusion and analysis of the results after treatment.Methods The study subjects were selected from the elderly patients with lumbar spinal stenosis admitted to the orthopedic department of Fengtai Hospital in Beijing.The remaining 40 patients who underwent pedicle screw internal fixation+posterior lateral bone graft fusion were included in the observation group.The two groups were compared in terms of implant fusion rate,surgical treatment,pain level and inflammatory factor level,complications,and lumbar spine function and quality of life.Results There was no significant difference in the fusion rate of the implants between the two groups(P>0.05).Compared with the control group,the observation group took less time and less intraoperative bleeding in terms of operative length and hospital days(P<0.05).In terms of VAS score,C-reactive protein(CRP)and interleukin-6(IL-6),the observation group was lower than the control group(P<0.05).Compared with the control group,the observation group had significantly lower complication rates and ODI scores,and significantly higher lumbar mobility and JOA scores(P<0.05).In terms of physical,environmental,psychological and social relationship scores,the observation group was higher than the control group(P<0.05).Conclusion For elderly patients with lumbar spinal stenosis,the treatment with pedicle screw internal fixation+posterior posterolateral graft fusion is effective,which can effectively improve the graft fusion rate,optimize the surgical situation,reduce the degree of pain and inflammatory injury,reduce the occurrence of postoperative complications,increase the mobility of the lumbar spine,and promote the rehabilitation of lumbar spine function,and can be further promoted in the clinical application.
作者
罗震宇
秦永超
安志军
夏文强
彭吉剑
Luo Zhenyu;Qin Yongchao;An Zhijun;Xia Wenqiang;Peng Jijian(Orthopedics Department,Beijing Fengtai Hospital,Beijing,100070,China)
出处
《中华骨与关节外科杂志》
CSCD
2023年第S01期124-127,共4页
Chinese Journal of Bone and Joint Surgery
基金
北京丰台医院院级科学研究项目,项目编号:2022-09。
关键词
腰椎管狭窄症
椎弓根螺钉内固定术
后外侧植骨融合术
Lumbar spinal stenosis
Pedicle screw internal fixation
Posterolateral bone grafting and fusion
