| 经椎间孔入路单枚融合器结合椎弓根钉治疗腰椎不稳 |
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投稿时间：2010-01-18
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| 作者 | Author | 单位 | Address | E-Mail |
| 王人彦 |
WANG Ren-yan |
富阳市中医骨伤医院,浙江 富阳 311400 |
The Orthopaedics and Traumatology Hospital of TCM of Fuyang City,Fuyang 311400,Zhejiang,China |
zjfygsyy@yahoo.cn |
| 华永均 |
HUA Yong-jun |
富阳市中医骨伤医院,浙江 富阳 311400 |
The Orthopaedics and Traumatology Hospital of TCM of Fuyang City,Fuyang 311400,Zhejiang,China |
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| 郭志辉 |
GUO Zhi-hui |
富阳市中医骨伤医院,浙江 富阳 311400 |
The Orthopaedics and Traumatology Hospital of TCM of Fuyang City,Fuyang 311400,Zhejiang,China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第4期，第248-250页 |
| DOI：10.3969/j.issn.1003-0034.2010.04.004 |
| 基金项目: |
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中文摘要:
目的：评价经椎间孔入路单枚椎间融合器植入结合椎弓根钉系统复位固定融合治疗腰椎不稳的应用价值。
方法：回顾性分析2006年至2009年腰椎不稳症患者36例39个间隙，其中男14例，女22例；年龄45～68岁，平均54岁；病程6个月～12年，平均4年。其中腰椎间盘突出症不稳8例，腰椎管狭窄症不稳5例，腰椎间盘突出症术后不稳3例，腰椎峡部裂20例；不稳定节段L3,4 2例，L4,518例，L5S113例，双节段3例(均为L4,5、L5S1).均采用经椎间孔入路单枚椎间融合器植入结合椎弓根钉系统，行减压、复位、内固定、椎体间及后外侧植骨融合等治疗，按照影像学结果及JOA评分进行疗效评定。
结果：36例均获随访，时间8～32个月，平均18个月。结果融合38个椎间隙，可疑融合1个椎间隙，融合率97.4%(38/39).影像学节段前凸角观察，术后较术前增大(4.09±0.13)°，经统计学分析差异有统计学意义(P<0.01),而随访时较术后虽有(3.83±0.17)°的减小，但两者无统计学差异(P>0.05).下腰痛JOA评分术前(8.14±1.09)分，末次随访(13.54±1.19)分，差异有统计学意义(P<0.01);同时根据JOA评分好转率(RIS)评定：优28例，良6例，中2例，优良率94.4%.
结论：经椎间孔入路单枚椎间融合器植入加椎弓根钉复位固定融合能简化手术操作、减少并发症，是治疗腰椎不稳的有效方法。 |
| 【关键词】腰椎不稳 脊柱融合术 椎弓根钉系统 |
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| Application of single interbody fusion cage with pedicle screws by transforaminal approach in treating lumbar instability |
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ABSTRACT
Objective: To evaluate the value of transforaminal approach single interbody fusion cage combining with fixation with pedicle screws in treating lumbar instability.
Methods: From 2006 to 2009,36 patients(39 interspaces) with lumbar instability were retrospectively analyzed,included 14 males and 22 females;aged from 45 to 68 years with an average of 54 years;course of disease was from 6 months to 12 years with an average of 4 years. Of them,instability in lumbar disc herniation had 8 cases,lumbar spinal stenosis 5 cases,postoperative instability in lumbar disc herniation 3 cases,lumbar spondylolysis 20 cases;unstable segment in L3,4 had 2 cases,L4,5 18 cases,L5S1 13 cases,and double segment 3 cases(both L4,5 and L5S1). All patients underwent decompression,reduction,interbody fusion with single cage from transforaminal approach with pedicle screws and posterolateral fusion. The clinical effects were evaluated according to imaging results and JOA scoring system.
Results: All the patients were followed up from 8 to 32 months with an average of 18 months. The results of 38 intervertebral fusion,suspicious fusion of a vertebral space,fusion rate was 97.4%(38/39). Segmental lordosis angle after operation was increased(4.09±0.13)° than before operation(P<0.01),and final follow-up was reduced(3.83±0.17)° than after operation(P>0.05). JOA scoring before operation and final follow-up were respectively 8.14±1.09 and 13.54±1.19,there was statistically significant between the two periods(P<0.01);the JOA score improvement rate(RIS):28 cases got excellent result,6 good and 2 fair,the rate of excellent and good was 94.4%.
Conclusion: The path through the transforaminal approach single-fusion cage,implantation of pedicle screw fixation fusion surgery can simplify operations,reduce complications,and can obtain satisfactory clinical efficacy,which is an effective method for the treatment of lumbar instability. |
| KEY WORDS Lumbar instability Spinal fusion Pedicle screw system |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王人彦,华永均,郭志辉.经椎间孔入路单枚融合器结合椎弓根钉治疗腰椎不稳[J].中国骨伤,2010,23(4):248~250 |
| 英文格式: | WANG Ren-yan,HUA Yong-jun,GUO Zhi-hui.Application of single interbody fusion cage with pedicle screws by transforaminal approach in treating lumbar instability[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(4):248~250 |
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