CAJ | 학술논문

为了比较后路椎间植骨融合(posterior lumber interbody fusion,PLIF)、后外侧植骨融合(posterolateral lumbar fu-sion,PLF)及二者联合运用(PLIF+PLF)在退行性腰椎滑脱症后路手术中的疗效,对59例退行性腰椎滑脱症患者根据手术中植骨方式分为三组,回顾三组患者的临床资料,比较三种植骨融合方式手术时间、术中出血量、椎间隙高度、滑脱角、植骨融合率以及JOA评分改善率.结果显示:B组(PLF)的植骨融合率低于A组(PLIF)及C组(PLIF+PLF).在椎问隙高度维持、滑脱角丢失等方面A组优于B组(P<0.05),并且与C组无差异(P>0.05).在手术时间及术中出血量方面A组优于C组(P<0.05),并且与B组无差异(P>0.05).JOA评分改善率比较,三组间无显著性差异(P>0.05).因此,得出结论:PLIF和PLF均是退行性腰椎滑脱症后路手术中的有效融合方式;PLIF及PLIF+PLF的融合率优于PLF;综合分析PLIF应用于退行性腰椎滑脱症后路手术中优于PLF及PLIF+PLF.
위료비교후로추간식골융합(posterior lumber interbody fusion,PLIF)、후외측식골융합(posterolateral lumbar fu-sion,PLF)급이자연합운용(PLIF+PLF)재퇴행성요추활탈증후로수술중적료효,대59례퇴행성요추활탈증환자근거수술중식골방식분위삼조,회고삼조환자적림상자료,비교삼충식골융합방식수술시간、술중출혈량、추간극고도、활탈각、식골융합솔이급JOA평분개선솔.결과현시:B조(PLF)적식골융합솔저우A조(PLIF)급C조(PLIF+PLF).재추문극고도유지、활탈각주실등방면A조우우B조(P<0.05),병차여C조무차이(P>0.05).재수술시간급술중출혈량방면A조우우C조(P<0.05),병차여B조무차이(P>0.05).JOA평분개선솔비교,삼조간무현저성차이(P>0.05).인차,득출결론:PLIF화PLF균시퇴행성요추활탈증후로수술중적유효융합방식;PLIF급PLIF+PLF적융합솔우우PLF;종합분석PLIF응용우퇴행성요추활탈증후로수술중우우PLF급PLIF+PLF.
To compare the clinical outcomes of posterior lumber interbody fusion(PLIF), posterolateral lumbar fusion(PLF)and PLIF associated with PLF(PLIF+PLF) for degenerative lumbar spondylolithesis. 59 patients were divided into three groups by the style of fusion. The three groups were compared for operating time, blood loss, fusion rate, disc space height,slipping angle and the rate of the improved JOA seore(RIS). The fusion rate of PLIF or PLIF+ PLF was higher than PLF(P<0.05). PLIF+PLF had more operating time and blood loss than PLIF or PLF(P<0. 05). PLF were worse than PLIF or PLIF+PLF for the disc space height and the slipping angle(P<0. 05). No statistical differences were found for the rate of the improved JOA score (RIS) of the three groups(P>0.05). Therefore, PLIF and PLF were both valid bone graft methods for degenerative lumbar spondylolithesis. The fusion rate of PLIF and PIAF+ PLF were higher than PI.F. Generally,PLIF was better than PLF or PLIF+PLF for degenerative lumbar spondylolisthesis.