CAJ | 학술논문

目的探讨椎弓根螺钉固定加单侧椎间植骨及单侧椎间融合器(cage)融合与椎弓根螺钉固定加双侧cage融合对治疗椎间盘突出症的疗效.方法随机抽取2006年1月至2011年5月收治且获得随访超过2年病例98例.根据融合方式分为A组(单侧椎间植骨及单枚cage椎间融合)和B组(双侧cage椎间融合).比较两组患者术中失血量、临床疗效和影像学结果等方面的差异.结果术中失血量A组(203.5±15.2) ml;B组(405.2±17.3) ml,两组差异有统计学意义(P＜0.05).A组优良率为92.8％;B组为92.6％.A组融合率为95.45％,B组为94.23％.两组间比较差异无统计学意义(P＞0.05).术后1周A组椎间高度为(11.2±1.2) mm;B组为(11.1±1.5) mm;术后2年A组为(11.0±1.2) mm;B组为(11.0±1.5) mm,两组术后椎间高度及2年后椎间高度丢失率比较差异无统计学意义(P＞0.05).结论在椎弓根螺钉系统内固定的基础上,无论单侧或双侧cage融合均能达到椎间融合率高、椎间高度丢失少、临床疗效良好的目的,但前者术中失血较少,费用相对较低.
목적 탐토추궁근라정고정가단측추간식골급단측추간융합기(cage)융합여추궁근라정고정가쌍측cage융합대치료추간반돌출증적료효.방법 수궤추취2006년1월지2011년5월수치차획득수방초과2년병례98례.근거융합방식분위A조(단측추간식골급단매cage추간융합)화B조(쌍측cage추간융합).비교량조환자술중실혈량、림상료효화영상학결과등방면적차이.결과 술중실혈량A조(203.5±15.2) ml;B조(405.2±17.3) ml,량조차이유통계학의의(P＜0.05).A조우량솔위92.8％;B조위92.6％.A조융합솔위95.45％,B조위94.23％.량조간비교차이무통계학의의(P＞0.05).술후1주A조추간고도위(11.2±1.2) mm;B조위(11.1±1.5) mm;술후2년A조위(11.0±1.2) mm;B조위(11.0±1.5) mm,량조술후추간고도급2년후추간고도주실솔비교차이무통계학의의(P＞0.05).결론 재추궁근라정계통내고정적기출상,무론단측혹쌍측cage융합균능체도추간융합솔고、추간고도주실소、림상료효량호적목적,단전자술중실혈교소,비용상대교저.
Objective To explore the clinical efficacy of pedicle screws-cod fixation plus single cage with autogenous bone and double cages implantation in treating lumbar disc herniation (LDH).Methods Ninety eight patients with LDH treated with posterior pedicle screw fixation and followed for more than two years were reviewed retrospectively from January 2006 to May 2011.All patients were divided into two group A (single cage interbody placement plus autogenous bone graft) and group B (double cages interbody placement) based on interbody fusion method.The volume of blood lose,clinical effect and imaging outcome of the two groups were compared.Results The blood lose during operation of group A was (203.5 ± 15.2) ml,while (405.2-± 17.3) ml of group B,and there was obvious difference of them (P ＜ 0.05).92.8％ cases of group A obtained excellent and good effect,while 92.6％ of group B did so.The fusion rate of group A was 95.45％,and group B reach to 94.23％.There was no diffence between them (P ＞ 0.05).At the 7th day after operation,the average intervertebral height of group A was (11.2 ± 1.2) mm,and those of group B was (11.1 ± 1.5) mm.Two years later,the average intervertebral height of group A was (11.0 ± 1.2) mm,while those of group B was (11.0 ± 1.5) mm.There was no difference between the two groups in intervertebral fusion rate and change of intervertebral height (P ＞ 0.05).Conclusion Based on posterior pedicle screw fixation,single or double cages interbody placement could achieve high rate of intervertebral fusion,rare change of intervertebral height and excellent therapeutic effect.However,internal fixation with single cage and autogenous undergo less fare and volume of blood lose.