中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
1期
96-99
,共4页
退行性腰椎失稳%椎弓根螺钉固定,单侧,双侧%椎间融合器
退行性腰椎失穩%椎弓根螺釘固定,單側,雙側%椎間融閤器
퇴행성요추실은%추궁근라정고정,단측,쌍측%추간융합기
Degenerative lumbar instability%Pedicle screw fixation,unilateral,bilateral%Interbody fusion
目的 探讨退行性腰椎失稳患者进行单侧椎弓根螺钉固定及椎间融合器与双侧椎弓根螺钉椎间融合器治疗的疗效情况.方法 选取广西骨伤医院在2009年1月至2010年1月进行椎弓根螺钉固定及椎间融合器的59例患者作为研究对象,依据患者病椎情况将患者分为单侧组(32例)及双侧组(27例).单侧组采用单侧椎弓根螺钉固定联合椎间融合器治疗,双侧组采用双侧椎弓根螺钉固定联合椎间融合器治疗.观察患者术后疗效、融合情况及并发症发生情况,同时对患者进行1年的随访,采用张立国等的评分方法进行近期疗效评价.结果 双侧组患者术后疗效优者11例,良者7例,可者9例;椎间融合Ⅰ级14例,Ⅱ级10例,Ⅲ级3例.单侧组患者优者20例,良者9例,可者3例;椎间融合Ⅰ级29例,Ⅱ级3例.单侧组发生并发症1例(3.1％),双侧组发生并发症4例(14.8％).2组患者术后疗效差异无统计学意义(P＞0.05),椎间融合情况差异有统计学意义(P＜0.01);并发症发生率差异无统计学意义(P＞0.05).术后进行随访,治疗后6、12个月,单侧组和双侧组与术前比较的张立国评分差异均有统计学意义[6个月:(4.8±0.6)分比(3.7±0.6)分;12个月:(4.9±0.6)分比(3.6±0.7)分;均P＜0.01].结论 临床上应用单侧椎弓根螺钉固定及椎间融合器在融合情况和近期疗效方面均优于双侧治疗方案,然而具体方案选择应视患者的腰椎病变情况而定.
目的 探討退行性腰椎失穩患者進行單側椎弓根螺釘固定及椎間融閤器與雙側椎弓根螺釘椎間融閤器治療的療效情況.方法 選取廣西骨傷醫院在2009年1月至2010年1月進行椎弓根螺釘固定及椎間融閤器的59例患者作為研究對象,依據患者病椎情況將患者分為單側組(32例)及雙側組(27例).單側組採用單側椎弓根螺釘固定聯閤椎間融閤器治療,雙側組採用雙側椎弓根螺釘固定聯閤椎間融閤器治療.觀察患者術後療效、融閤情況及併髮癥髮生情況,同時對患者進行1年的隨訪,採用張立國等的評分方法進行近期療效評價.結果 雙側組患者術後療效優者11例,良者7例,可者9例;椎間融閤Ⅰ級14例,Ⅱ級10例,Ⅲ級3例.單側組患者優者20例,良者9例,可者3例;椎間融閤Ⅰ級29例,Ⅱ級3例.單側組髮生併髮癥1例(3.1％),雙側組髮生併髮癥4例(14.8％).2組患者術後療效差異無統計學意義(P＞0.05),椎間融閤情況差異有統計學意義(P＜0.01);併髮癥髮生率差異無統計學意義(P＞0.05).術後進行隨訪,治療後6、12箇月,單側組和雙側組與術前比較的張立國評分差異均有統計學意義[6箇月:(4.8±0.6)分比(3.7±0.6)分;12箇月:(4.9±0.6)分比(3.6±0.7)分;均P＜0.01].結論 臨床上應用單側椎弓根螺釘固定及椎間融閤器在融閤情況和近期療效方麵均優于雙側治療方案,然而具體方案選擇應視患者的腰椎病變情況而定.
목적 탐토퇴행성요추실은환자진행단측추궁근라정고정급추간융합기여쌍측추궁근라정추간융합기치료적료효정황.방법 선취엄서골상의원재2009년1월지2010년1월진행추궁근라정고정급추간융합기적59례환자작위연구대상,의거환자병추정황장환자분위단측조(32례)급쌍측조(27례).단측조채용단측추궁근라정고정연합추간융합기치료,쌍측조채용쌍측추궁근라정고정연합추간융합기치료.관찰환자술후료효、융합정황급병발증발생정황,동시대환자진행1년적수방,채용장입국등적평분방법진행근기료효평개.결과 쌍측조환자술후료효우자11례,량자7례,가자9례;추간융합Ⅰ급14례,Ⅱ급10례,Ⅲ급3례.단측조환자우자20례,량자9례,가자3례;추간융합Ⅰ급29례,Ⅱ급3례.단측조발생병발증1례(3.1％),쌍측조발생병발증4례(14.8％).2조환자술후료효차이무통계학의의(P＞0.05),추간융합정황차이유통계학의의(P＜0.01);병발증발생솔차이무통계학의의(P＞0.05).술후진행수방,치료후6、12개월,단측조화쌍측조여술전비교적장입국평분차이균유통계학의의[6개월:(4.8±0.6)분비(3.7±0.6)분;12개월:(4.9±0.6)분비(3.6±0.7)분;균P＜0.01].결론 림상상응용단측추궁근라정고정급추간융합기재융합정황화근기료효방면균우우쌍측치료방안,연이구체방안선택응시환자적요추병변정황이정.
Objective To compare the efficacy of unilateral pedicle screws combined interbody fusion and bilateral pedicle screws combined interbody fusion in the treatment of degenerative lunbar instability.Methods All 59 patients treated with pedicle screws combined interbody fusion in guangxi orthopedics hospital from January 2009 to January 2010 were selected as research subject,and all patients were divided into unilateral treatment group (32 eases)and bilateral treatment group (27 cases) based on patients vertebral disease.The efficacy,fusion as well as occurrence of complications were compared,while patients with one year follow-up,shortterm efficacy evaluated by Zhang Liguo scoring method.Results Twenty cases with excellent efficacy,9 cases with good efficacy,3 cases with general efficacy; 29 cases with grade Ⅰ interbody fusion,3 cases with grade Ⅱinterbody fusion in the unilateral treatment group.Eleven cases with excellent efficacy,7 cases with good efficacy,9 cases with general efficacy,14 cases with grade Ⅰ interbody fusion,10 cases with grade Ⅱ interbody fusion,3 cases with grade Ⅲ interbody fusion in the bilateral treatment group.One case (3.7 ％) had complications in the unilateral treatment group; 4 cases (12.5 ％) had complications in the bilateral treatment group,and there was no significant difference in efficacy (P ＞ 0.05).The Zhang Liguo score showed significant differences between unilateral and bilateral groups 6 and 12 months after treatment [the 6 months:(4.8 ± 0.6) scores vs (3.7 ±0.6) scores; the 12 month:(4.9±0.6) scores vs (3.6±0.7) scores,all P＜0.01].Conclusion The convergence as well as short-term efficacy in unilateral treatment group are better than thoses in the bilateral treatment group.
