中国骨与关节杂志
中國骨與關節雜誌
중국골여관절잡지
Chinese Journal of Bone and Joint
2015年
8期
655-660
,共6页
樊勇%杨红军%雷伟%吴子祥%严亚波%张扬%桑宏勋
樊勇%楊紅軍%雷偉%吳子祥%嚴亞波%張颺%桑宏勛
번용%양홍군%뢰위%오자상%엄아파%장양%상굉훈
骨质疏松%腰椎%脊柱融合术%骨水泥成形术%内固定器
骨質疏鬆%腰椎%脊柱融閤術%骨水泥成形術%內固定器
골질소송%요추%척주융합술%골수니성형술%내고정기
Osteoporosis%Lumbar vertebrae%Spinal fusion%Cementoplasty%Internal ifxators
目的:分析总结普通椎弓根螺钉与骨水泥型椎弓根螺钉在骨质疏松患者脊柱手术中的临床应用情况,综合评价新型骨水泥型椎弓根螺钉的安全性及可靠性。方法2009年1月至2013年5月,对227例合并骨质疏松的胸腰椎疾病患者进行后路椎板切除减压椎体间融合术,其中普通椎弓根螺钉组151例,男86例,女65例,平均年龄(71.4±6.7)岁;新型骨水泥型椎弓根螺钉组76例,男42例,女34例,平均年龄(73.1±7.0)岁。比较两组患者在手术时间、出血量、术后12个月疼痛视觉模拟评分( visual analogue scale, VAS )、Oswestry 功能障碍指数( oswestry disability index,ODI )以及螺钉松动率、椎间融合情况。结果骨水泥型椎弓根螺钉组无螺钉松动、断裂,所有病例获得椎体间植骨愈合;术后12个月的 VAS 和 ODI 评分分别为(2.0±0.5)分和(24.0±4.5),明显优于普通螺钉组的(1.7±0.5)分和(21.7±5.0),差异有统计学意义( P<0.05);普通椎弓根螺钉组出现26枚螺钉松动,松动率为3.3%。结论在骨质疏松腰椎内固定手术中,新型骨水泥型椎弓根螺钉较普通椎弓根螺钉具有更低的螺钉松动率,无骨水泥椎管内渗漏并发症,临床安全性高,近期效果满意,为骨质疏松患者手术提供了一种新型、可靠的内固定选择。
目的:分析總結普通椎弓根螺釘與骨水泥型椎弓根螺釘在骨質疏鬆患者脊柱手術中的臨床應用情況,綜閤評價新型骨水泥型椎弓根螺釘的安全性及可靠性。方法2009年1月至2013年5月,對227例閤併骨質疏鬆的胸腰椎疾病患者進行後路椎闆切除減壓椎體間融閤術,其中普通椎弓根螺釘組151例,男86例,女65例,平均年齡(71.4±6.7)歲;新型骨水泥型椎弓根螺釘組76例,男42例,女34例,平均年齡(73.1±7.0)歲。比較兩組患者在手術時間、齣血量、術後12箇月疼痛視覺模擬評分( visual analogue scale, VAS )、Oswestry 功能障礙指數( oswestry disability index,ODI )以及螺釘鬆動率、椎間融閤情況。結果骨水泥型椎弓根螺釘組無螺釘鬆動、斷裂,所有病例穫得椎體間植骨愈閤;術後12箇月的 VAS 和 ODI 評分分彆為(2.0±0.5)分和(24.0±4.5),明顯優于普通螺釘組的(1.7±0.5)分和(21.7±5.0),差異有統計學意義( P<0.05);普通椎弓根螺釘組齣現26枚螺釘鬆動,鬆動率為3.3%。結論在骨質疏鬆腰椎內固定手術中,新型骨水泥型椎弓根螺釘較普通椎弓根螺釘具有更低的螺釘鬆動率,無骨水泥椎管內滲漏併髮癥,臨床安全性高,近期效果滿意,為骨質疏鬆患者手術提供瞭一種新型、可靠的內固定選擇。
목적:분석총결보통추궁근라정여골수니형추궁근라정재골질소송환자척주수술중적림상응용정황,종합평개신형골수니형추궁근라정적안전성급가고성。방법2009년1월지2013년5월,대227례합병골질소송적흉요추질병환자진행후로추판절제감압추체간융합술,기중보통추궁근라정조151례,남86례,녀65례,평균년령(71.4±6.7)세;신형골수니형추궁근라정조76례,남42례,녀34례,평균년령(73.1±7.0)세。비교량조환자재수술시간、출혈량、술후12개월동통시각모의평분( visual analogue scale, VAS )、Oswestry 공능장애지수( oswestry disability index,ODI )이급라정송동솔、추간융합정황。결과골수니형추궁근라정조무라정송동、단렬,소유병례획득추체간식골유합;술후12개월적 VAS 화 ODI 평분분별위(2.0±0.5)분화(24.0±4.5),명현우우보통라정조적(1.7±0.5)분화(21.7±5.0),차이유통계학의의( P<0.05);보통추궁근라정조출현26매라정송동,송동솔위3.3%。결론재골질소송요추내고정수술중,신형골수니형추궁근라정교보통추궁근라정구유경저적라정송동솔,무골수니추관내삼루병발증,림상안전성고,근기효과만의,위골질소송환자수술제공료일충신형、가고적내고정선택。
Objective To analyze clinical applications of traditional pedicle screws and cement-augmented pedicle screws in osteoporotic spine surgery, and to evaluate the safety and feasibility of novel cement-augmented pedicle screws.Methods From January, 2009 to May 2013, 227 cases of thoracolumbar spine diseases combined with osteoporosis were enrolled and underwent posterior laminectomy decompression and lumbar interbody fusion. One hundred and fifty-one cases received traditional pedicle screws ( 86 males, 65 females, the mean age: 71.4± 6.7 years ). Seventy-six cases received cement-augmented pedicle screws ( 42 males, 34 females, the mean age: 73.1± 7.0 years ). Operation time and blood loss volume in 2 groups were recorded. Visual analogue scale ( VAS ), Oswestry disability index ( ODI ), rate of screw loosening and fusion conditions were compared 12 months postoperatively. Results In cement-augmented pedicle screw group, all patients achieved spinal fusion without any screw loosening or breakage. VAS score and ODI score were 2.0±0.5 and 24.0±4.5 12 months postoperatively, which were signiifcant superior to those in traditional pedicle screw group ( VAS score and ODI score: 1.7±0.5 and 21.7±5.0 ) with statistical signiifcance (P<0.05 ). In contrast, 26 traditional pedicle screws loosened with a loosening rate of 3.3%.Conclusions In osteoporotic spine operation, cement-augmented screws can provideexcellent ifxation stability as well as safety, with lower incidence rate of loosening and spinal canal leakage. It provides a novel ifxation method for osteoporotic spinal surgery.