CAJ | 학술논문

背景：近年来椎管减压复位内固定联合植骨融合已在临床上广泛应用，双侧椎弓根螺钉辅助椎体间植骨融合及单侧椎弓根螺钉辅助椎体间植骨融合是治疗老年退行性椎管狭窄及腰椎滑脱的主要方法。目的：对比双侧及单侧椎弓根螺钉辅助椎体间融合器植骨融合治疗老年椎管狭窄合并退行性腰椎滑脱的早期临床疗效。方法：纳入60例老年椎管狭窄合并退行性腰椎滑脱患者，其中男37例，女23例，年龄60-78岁，分两组治疗，两组均行椎管减压，治疗组(n=30)行单侧椎弓根螺钉辅助椎体间融合器植骨融合治疗，对照组(n=30)行双侧椎弓根螺钉辅助椎体间融合器植骨融合治疗。治疗后随访1年，以JOA评分评估两组关节功能恢复情况，同时记录并发症情况。结果与结论：治疗组与对照组JOA评分分别为25.7±1.9，25.8±1.8，组间比较差异无显著性意义。治疗组有3例出现下肢麻木，2例发生硬膜撕裂，并发症发生率为17%；对照组3例出现下肢麻木，3例出现硬膜撕裂，并发症发生率为20%，组间并发症发生率比较差异无显著性意义，两组均未发生与植骨材料相关的不良反应。表明采用双侧或单侧椎弓根螺钉辅助椎体间融合器骨植骨融合治疗老年退行性椎管狭窄合并腰椎滑脱均有较好的疗效。
배경：근년래추관감압복위내고정연합식골융합이재림상상엄범응용，쌍측추궁근라정보조추체간식골융합급단측추궁근라정보조추체간식골융합시치료노년퇴행성추관협착급요추활탈적주요방법。목적：대비쌍측급단측추궁근라정보조추체간융합기식골융합치료노년추관협착합병퇴행성요추활탈적조기림상료효。방법：납입60례노년추관협착합병퇴행성요추활탈환자，기중남37례，녀23례，년령60-78세，분량조치료，량조균행추관감압，치료조(n=30)행단측추궁근라정보조추체간융합기식골융합치료，대조조(n=30)행쌍측추궁근라정보조추체간융합기식골융합치료。치료후수방1년，이JOA평분평고량조관절공능회복정황，동시기록병발증정황。결과여결론：치료조여대조조JOA평분분별위25.7±1.9，25.8±1.8，조간비교차이무현저성의의。치료조유3례출현하지마목，2례발생경막시렬，병발증발생솔위17%；대조조3례출현하지마목，3례출현경막시렬，병발증발생솔위20%，조간병발증발생솔비교차이무현저성의의，량조균미발생여식골재료상관적불량반응。표명채용쌍측혹단측추궁근라정보조추체간융합기골식골융합치료노년퇴행성추관협착합병요추활탈균유교호적료효。
BACKGROUND:Spinal canal decompression reduction fixation combined with bone graft fusion has been extensively applied in the clinic. Bilateral pedicle screw assisted interbody fusion and unilateral pedicle screw assisted interbody fusion are main methods to treat degenerative lumbar spinal stenosis and lumbar spondylolisthesis. OBJECTIVE:To compare early clinical therapeutic effects of bilateral and unilateral pedicle screw assisted interbody fusion in elderly patients with spinal stenosis and degenerative spondylolisthesis. METHODS:A total of 60 elderly patients with spinal stenosis with degenerative lumbar spondylolisthesis were selected, including 37 males and 23 females, at the age of 60 to 78 years old. They were divided into two groups, and subjected to decompression of spinal canal. In the treatment group (n=30), patients received unilateral pedicle screw assisted interbody fusion. In the control group (n=30), patients received bilateral pedicle screw assisted interbody fusion. After treatment, they were folowed up for 1 year. The recovery of joint function was assessed using Japanese Orthopaedic Association scores in both groups. Simultaneously, complications were recorded. RESULTS AND CONCLUSION:Japanese Orthopaedic Association scores were 25.7±1.9 and 25.8±1.8 in the treatment and control groups, respectively, and no significant difference was found between groups. In the treatment group, three cases affected lower limb numbness and two cases suffered from dural tear, with the incidence of complication of 17%. In the control group, three cases affected lower limb numbness and three cases suffered from dural tear, with the incidence of complication of 20%; no significant difference was detected between the two groups. No adverse reaction related to bone graft was found in the two groups. These results confirm that bilateral or unilateral pedicle screw assisted interbody fusion in treatment of degenerative lumbar spondylolisthesis with spinal stenosis obtained good therapeutic effects.