CAJ | 학술논문

目的：探讨腰椎后路椎间植骨融合术（PLIF）手术治疗退行性腰椎管狭窄症伴腰椎失稳的疗效。方法回顾分析2006年7月～2011年10月使用 PLIF 手术方式治疗的退行性腰椎管狭窄伴腰椎失稳患者75例，46例采用单节段减压植骨椎弓根螺钉系统内固定，29例采用多节段减压植骨椎弓根螺钉系统内固定。结果随访1～5年，平均1年8个月，根据 JOA 评分，优37例，良30例，中 6例，差2例，优良率达89．33％，无断钉、松动或围手术期死亡。所有病例术后1年 CT 扫描可见骨性融合；椎间隙高度术后7 d 平均为（11．2±1．1）mm，末次随访为（11．0±1．1）mm。椎间高度术后7 d 与末次随访比较差异无统计学意义（P ＞0．05）。结论PLIF 治疗退行性腰椎管狭窄症伴腰椎失稳可提供彻底的减压效果和椎间稳定性，临床效果满意。
목적：탐토요추후로추간식골융합술（PLIF）수술치료퇴행성요추관협착증반요추실은적료효。방법회고분석2006년7월～2011년10월사용 PLIF 수술방식치료적퇴행성요추관협착반요추실은환자75례，46례채용단절단감압식골추궁근라정계통내고정，29례채용다절단감압식골추궁근라정계통내고정。결과수방1～5년，평균1년8개월，근거 JOA 평분，우37례，량30례，중 6례，차2례，우량솔체89．33％，무단정、송동혹위수술기사망。소유병례술후1년 CT 소묘가견골성융합；추간극고도술후7 d 평균위（11．2±1．1）mm，말차수방위（11．0±1．1）mm。추간고도술후7 d 여말차수방비교차이무통계학의의（P ＞0．05）。결론PLIF 치료퇴행성요추관협착증반요추실은가제공철저적감압효과화추간은정성，림상효과만의。
Objective To discuss clinical efficacy of posterior lumbar interbody fusion (PLIF)surgery for the treatment of degenerative lumbar spinal stenosis and instability. Methods From July 2006 to October 2011,75 patients with degenerative lumbar spinal stenosis and instability were treated by PLIF,46 of them re-ceived single-segment decompression interbody fusion with pedicle screw system internal fixation,29 of them received multi-segment decompression interbody fusion with pedicle screw system internal fixation. Results All patients were followed up for 12~60 months,with the average time of 20 months.Clinical outcome was evaluated by using JOA ,37 cases obtained excellent results,30 good,6 fair and 2 poor,the satisfactory rate was 89.33%,no nails break or loose,no peri-operative death.Solid bony fusion could be obtained by assess-ment using computed tomography (CT)scanning in all patients 1 year after operation.The mean intervertebral height maintained (11.2±1.1)mm on day 7 postoperatively and (11.0±1.1)mm at final follow-up.There were no statistical difference in comparison of postoperative intervertebral height between the seventh day and final follow-up (P >0.05). Conclusion There is good therapeutic effectiveness of PLIF for treating degen-erative lumbar spinal stenosis and instability in decompression and keeping intervertebral stability.