| 椎间融合加椎弓根螺钉内固定治疗退变性腰椎不稳的疗效分析 |
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Received:June 24, 2004
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| 作者 | Author | 单位 | Unit | E-Mail |
| 赵铁军 |
ZHAO Tie-jun |
中国中医研究院望京医院骨关节一科, 北京 100102 |
Department of the 1 st Bone and Joint Surgery, WangJing Hospital, China Academy of Traditional Chinese Medicine |
wangqiangas79@hotmail.com |
| 张洪美 |
ZHANG Hong-mei |
中国中医研究院望京医院骨关节一科, 北京 100102 |
Department of the 1 st Bone and Joint Surgery, WangJing Hospital, China Academy of Traditional Chinese Medicine |
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| 陈卫衡 |
CHENWei-heng |
中国中医研究院望京医院骨关节一科, 北京 100102 |
Department of the 1 st Bone and Joint Surgery, WangJing Hospital, China Academy of Traditional Chinese Medicine |
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| 顾力军 |
GU Li-jun |
中国中医研究院望京医院骨关节一科, 北京 100102 |
Department of the 1 st Bone and Joint Surgery, WangJing Hospital, China Academy of Traditional Chinese Medicine |
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| 张磊 |
ZHANG Lei |
中国中医研究院望京医院骨关节一科, 北京 100102 |
Department of the 1 st Bone and Joint Surgery, WangJing Hospital, China Academy of Traditional Chinese Medicine |
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| 孙钢 |
SUN Gang |
中国中医研究院望京医院骨关节一科, 北京 100102 |
Department of the 1 st Bone and Joint Surgery, WangJing Hospital, China Academy of Traditional Chinese Medicine |
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| 期刊信息：《中国骨伤》2004年17卷，第10期，第602-604页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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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(JOAscore)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。 |
| [关键词]:腰椎 关节不稳定性 关节融合术 内固定 |
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| Analysis on the therapeutic effect of degenerative lumbar instability with transpedicular screw fixation combined with the posterior lumbar interbody fusion with cages |
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Abstract:
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. |
| KEYWORDS:Lumbar vertebrae Joint instability Arthrodesis Internal fixation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 赵铁军,张洪美,陈卫衡,顾力军,张磊,孙钢.椎间融合加椎弓根螺钉内固定治疗退变性腰椎不稳的疗效分析[J].中国骨伤,2004,17(10):602~604 |
| 英文格式: | ZHAO Tie-jun,ZHANG Hong-mei,CHENWei-heng,GU Li-jun,ZHANG Lei,SUN Gang.Analysis on the therapeutic effect of degenerative lumbar instability with transpedicular screw fixation combined with the posterior lumbar interbody fusion with cages[J].zhongguo gu shang / China J Orthop Trauma ,2004,17(10):602~604 |
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