PEEK椎间融合器附加椎弓根钉内固定行椎间融合的临床应用研究

首都医科大学学报 ›› 2008, Vol. 29 ›› Issue (6): 709-711.

PEEK椎间融合器附加椎弓根钉内固定行椎间融合的临床应用研究

李锦军, 李东, 杨雍, 杨金江, 王炳强

首都医科大学附属北京友谊医院骨科

收稿日期:2008-10-18 修回日期:1900-01-01 出版日期:2008-12-24 发布日期:2008-12-24

Studies on Surgical Decompression,Posterior Lumbar Interbody Fusion and Pedicle Screw Fixation for the Treatment of Lumbar Degenerative Diseases

Li Jinjun, Li Dong, Yang Yong, Yang Jinjiang, Wang Bingqiang

Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University

Received:2008-10-18 Revised:1900-01-01 Online:2008-12-24 Published:2008-12-24

摘要/Abstract

摘要： 目的评价应用PEEK(polyetheretherketone)椎间融合器附加椎弓根钉内同定行椎间融合治疗腰椎退行性疾病的临床疗效.方法总结了44例随访1～5年的腰椎退行性疾病手术患者,其中男性18例,女性26例,年龄33～72岁,平均49.2岁,腰椎间盘突出症36例,腰椎滑脱8例,其中合并腰椎管狭窄17例,行单节段融合35例,双节段融合9例.对其术前和随访时的日本骨科学会(JOA)评分进行比较.并通过术前、术后及随访时X线片对比,对椎问高度变化、融合率和相邻节段的退变进行了评估.结果术前JOA评分平均为(15.4±7.2)分,术后随访1、3、5年时分别为(23.3±3.8)、(23.5±3.7)和(24.0±4.6)分,应用方差分析进行统计学处理,显示术前和术后随访时差异有统计学意义,术前融合节段椎间隙平均高度为(7.6±2.8)mm,术后为(10.3±2.6)mm,术后随访1、3、5年时分别为(10.3±2.6)mm、(10.1±2.2)mm和(8.9±2.2)mm,术前和术后差异有统计学意义,随访时有轻度高度丢失,但与术后差异无统计学意义.随访时融合率为95.5%,发现融合邻近节段病变3例,均为椎间隙变窄.无手术合并症发生.结论应用PEEK椎间融合器附加椎弓根钉内固定行椎间融合治疗腰椎退行性疾病可有效恢复椎间高度,提高融合率,是一种有效的治疗方法.

关键词: 腰椎退行性疾患, 椎弓根钉内固定, PEEK椎间融合器, 椎问融合

Abstract: Objective To study the effects of surgical decompression,posterior lumbar interbody fusion and pedicle screw fixation for the treatment of lumbar degenerative diseases.Methods There were 44 patients who were treated with laminectomy,discectomy,nerve root loosening,posterior lumbar interbody fusion and pedicle screw fixation between the years 2000 and 2005.Of these were 18 males and 26 females,aging from 33 to 72(with a mean age of 49.2).The patients included 36 disk hernation,8 spondylolisthesis and 17 combined lumbar stenosis.For the treatment,35 patients were carried on operation of single interbody fusion and 9 with two interbody fusion and the follow-up investigation lasted for 1～5 years.Clinical status was evaluated by the Japanese Orthopaedic Association(JOA) score preoperation and at 3,6,12,24,36,48,60 months postoperation.The fusion rate was evaluated by lumbar X-ray.Results Fusion rate was 95.5% on the first year postoperatively.JOAscore of follow-up investigations increased significantly than that of preoperation,the average space between disks postoperation decreased significantly than that of preoperation,but it has lost when compared the height of disk postoperation with follow-up after surgery.Conclusion Surgical decompression,postural lumbar interbody fusion and pedicle screw fixation is an effective method for the treatment of lumbar degenerative diseases.

Key words: lumbar degenerative diseases, pedicle screw fixation, PEEK cage, posteral lumbar interbody fusion

中图分类号:

R681.5⁺7

李锦军;李东;杨雍;杨金江;王炳强. PEEK椎间融合器附加椎弓根钉内固定行椎间融合的临床应用研究[J]. 首都医科大学学报, 2008, 29(6): 709-711.

Li Jinjun;Li Dong;Yang Yong;Yang Jinjiang;Wang Bingqiang. Studies on Surgical Decompression,Posterior Lumbar Interbody Fusion and Pedicle Screw Fixation for the Treatment of Lumbar Degenerative Diseases[J]. Journal of Capital Medical University, 2008, 29(6): 709-711.