發(fā)布時間：2018-01-29 18:42

  本文關(guān)鍵詞： 骨質(zhì)疏松癥 腰椎融合術(shù) 椎弓根螺釘　出處：《中國脊柱脊髓雜志》2017年02期 　論文類型：期刊論文

【摘要】：目的:分析膨脹式椎弓根螺釘在骨質(zhì)疏松患者腰椎短節(jié)段固定融合手術(shù)中應(yīng)用的中期療效。方法:回顧性分析2007年1月~2013年7月行腰椎后路固定融合術(shù)且獲得3年以上隨訪資料的患者406例,其中男147例,女259例,年齡50~79歲(63.4±4.2歲),術(shù)前腰椎骨密度T值為-3.3±0.6(-2.5~-4.6)。根據(jù)術(shù)中使用椎弓根螺釘種類的不同,分為膨脹式椎弓根螺釘(EPS)組(n=173)和普通椎弓根螺釘(CPS)組(n=233)。兩組患者的性別構(gòu)成、術(shù)前骨密度T值、疾病類型、隨訪時間均無統(tǒng)計學(xué)差異(P0.05)。術(shù)前、術(shù)后3個月、術(shù)后6個月及末次隨訪時采用VAS和Oswestry功能障礙指數(shù)(Oswestry disability index,ODI)進行評價。根據(jù)術(shù)后每次隨訪時拍攝的X線片或CT情況,比較兩組患者的脊柱融合率、螺釘松動率及斷釘情況。結(jié)果:所有患者隨訪時間為3~8年(3.7±1.0年)。兩組患者術(shù)前VAS評分和ODI評分均無統(tǒng)計學(xué)差異(P0.05);兩組術(shù)后3個月、6個月和末次隨訪時的VAS評分和ODI評分均較術(shù)前顯著改善(P0.05);術(shù)后3個月、6個月和末次隨訪時,EPS組患者VAS評分及ODI評分均明顯低于CPS組(P0.05)。EPS組中,1例(0.6%,1/173)患者的2枚(0.3%,2/796)螺釘出現(xiàn)松動,5例(2.9%,5/173)患者的7枚(0.9%,7/796)螺釘出現(xiàn)斷裂;CPS組中,13例(5.6%,13/233)患者的17枚(1.8%,17/960)螺釘出現(xiàn)松動,2例(0.9%,2/233)患者的4枚(0.4%,4/960)螺釘出現(xiàn)斷裂。EPS組螺釘松動率顯著低于CPS組(P0.05),螺釘斷裂率與CPS組比較無統(tǒng)計學(xué)差異(P0.05)。EPS組融合成功率(99.4%,172/173)顯著高于CPS組(93.6%,218/233)(P0.05)。結(jié)論:在骨質(zhì)疏松患者腰椎短節(jié)段固定融合手術(shù)中,使用膨脹式椎弓根螺釘相比普通椎弓根螺釘具有更低的螺釘松動率和更高的脊柱融合率,是一種安全可靠的手術(shù)方案。
[Abstract]:Objective: to analyze the curative effect of middle expansive pedicle screw surgery in patients with osteoporosis and lumbar fusion in short segment fixation. Methods: a retrospective analysis of 406 cases of patients with posterior lumbar ~2013 January 2007 July arthrodesis and followed up more than 3 years of data, of which 147 cases were male, 259 were female, aged 50~79 years (63.4. At the age of 4.2), preoperative lumbar bone mineral density T value is -3.3 + 0.6 (-2.5~-4.6). According to the use of pedicle screw type patients were divided into expandable pedicle screw (EPS) group (n=173) and conventional pedicle screw (CPS) group (n= 233). The two groups of patients with gender, preoperative bone mineral density T value, the type of disease, there was no significant difference of follow-up time (P0.05). Before surgery, 3 months after surgery, 6 months after operation and the last follow-up of the VAS and Oswestry disability index (Oswestry disability index, ODI) were evaluated. According to the shooting time at the follow-up of X 綰跨墖鎴朇T鎯呭喌,姣旇緝涓ょ粍鎮(zhèn)ｈ，

本文編號：1474096