CAJ | 학술논문

背景：腰椎滑脱修复的主要目的是恢复并重建脊柱序列的稳定性，解除突出的椎间盘对神经根的压迫，椎弓根钉棒系统加植骨融合成为多数学者治疗腰椎滑脱的首选方式。国内外多数学者在选择修复方式时倾向于后路椎间植骨融合或者后外侧椎间植骨融合。 　　目的：通过观察植骨融合率及椎间隙丢失高度，对比退变性腰椎滑脱患者行后路自体髂骨椎间植骨融合与后路Cage椎间融合器植骨融合的临床疗效。 　　方法：选取2008年7月至2013年12月宣城中心医院收治的61例退变性腰椎滑脱患者，按照椎间植骨融合方式分为两组，自体髂骨组37例行后路自体髂骨椎间植骨融合治疗，Cage椎间融合器组24例行后路Cage椎间融合器植骨融合治疗。对比两组患者的手术时间、失血量、滑脱复位情况、植骨融合情况及 JOA评分，探讨不同椎间植骨融合方式对退变性腰椎滑脱患者预后的指导意义。 　　结果与结论：两组患者的失血量相比差异无显著性意义(P >0.05)；但自体髂骨组的手术时间显著长于Cage椎间融合器组(P<0.05)。两组患者均取得了较好的复位率、植骨融合率及临床疗效改善率，两组相比差异无显著性意义(P>0.05)。两组患者的末次随访椎间隙丢失高度相比差异有显著性意义(P<0.05)，Cage椎间融合器组优于自体髂骨组。提示两种植骨融合方式修复腰椎滑脱均可取得良好的复位及临床效果，但长期随访后路Cage椎间融合器植骨融合的椎间隙丢失高度较小，临床修复效果更佳。
배경：요추활탈수복적주요목적시회복병중건척주서렬적은정성，해제돌출적추간반대신경근적압박，추궁근정봉계통가식골융합성위다수학자치료요추활탈적수선방식。국내외다수학자재선택수복방식시경향우후로추간식골융합혹자후외측추간식골융합。 　　목적：통과관찰식골융합솔급추간극주실고도，대비퇴변성요추활탈환자행후로자체가골추간식골융합여후로Cage추간융합기식골융합적림상료효。 　　방법：선취2008년7월지2013년12월선성중심의원수치적61례퇴변성요추활탈환자，안조추간식골융합방식분위량조，자체가골조37례행후로자체가골추간식골융합치료，Cage추간융합기조24례행후로Cage추간융합기식골융합치료。대비량조환자적수술시간、실혈량、활탈복위정황、식골융합정황급 JOA평분，탐토불동추간식골융합방식대퇴변성요추활탈환자예후적지도의의。 　　결과여결론：량조환자적실혈량상비차이무현저성의의(P >0.05)；단자체가골조적수술시간현저장우Cage추간융합기조(P<0.05)。량조환자균취득료교호적복위솔、식골융합솔급림상료효개선솔，량조상비차이무현저성의의(P>0.05)。량조환자적말차수방추간극주실고도상비차이유현저성의의(P<0.05)，Cage추간융합기조우우자체가골조。제시량충식골융합방식수복요추활탈균가취득량호적복위급림상효과，단장기수방후로Cage추간융합기식골융합적추간극주실고도교소，림상수복효과경가。
BACKGROUND:The major aim of repair of lumbar spondylolisthesis is to restore and reconstruct the stability of spine sequence, and to relieve compression of herniated disc on nerve root. Pedicle screw system and bone graft fusion become the preferred way to treat spondylolisthesis of most scholars. Most scholars are prone to posterior interbody fusion or posterolateral interbody fusion. OBJECTIVE:To compare the clinical curative effects of posterior autologous iliac bone graft fusion and posterior Cage intervertebral bone graft fusion in patients with degenerative lumbar spondylolisthesis by observing fusion rate and height of intervertebral loss. METHODS:A total of 61 patients with degenerative lumbar spondylolisthesis in Xuancheng Central Hospital from July 2008 to December 2013 were enrol ed in this study. According to the different types of interbody fusion, 37 cases in autologous ilium group received posterior autologous iliac bone graft fusion. 24 cases in the Cage interbody fusion cage group underwent posterior Cage interbody fusion cage fusion. Operation time, blood loss, spondylolisthesis reduction, graft fusion and Japanese Orthopaedic Association score were compared between  the two groups. The significance of different fusion manners on prognosis was explored in patients with degenerative lumbar spondylolisthesis. RESULTS AND CONCLUSION:No significant difference in blood loss was detected between the two groups (P>0.05). However, the operation time was significantly longer in the autologous ilium group than in the Cage interbody fusion cage group (P<0.05). The reduction rate, bone graft fusion rate and improvement rate of clinical curative effects were good in both groups, and no significant difference was detectable in above indexes between the two groups (P>0.05). Significant difference in the height of intervertebral loss was detectable between the two groups in final fol ow-up (P<0.05). The height of intervertebral loss was better in the Cage interbody fusion cage group than in the autologous ilium group. These findings indicate that two kinds of bone graft fusion manners for lumbar spondylolisthesis obtained good reduction and clinical curative effects, but the height of intervertebral loss was smal in the Cage interbody fusion cage fusion during long-period fol ow-up, and the clinical effect was good.