骨水泥强化椎弓根钉内固定在老年退行性腰椎管狭窄症手术治疗中的应用
摘要
目的探讨骨水泥强化椎弓根钉内固定治疗老年退行性腰椎管狭窄症的临床疗效。方法回顾性分析自2014-02—2017-02诊治的64例老年退行性腰椎管狭窄症,观察组32例行骨水泥强化椎弓根钉内固定、减压融合术,对照组32例行椎弓根钉内固定、减压融合但未进行骨水泥强化。结果 64例均获得随访,随访时间12(10～18)个月。观察组未出现骨水泥渗漏及骨水泥毒性反应。观察组未出现螺钉松动,对照组有3例螺钉松动;观察组螺钉松动发生率低于对照组,但差异无统计学意义(P>0.05)。观察组与对照组术后疼痛VAS评分、JOA评分、ODI指数较术前明显改善,差异有统计学意义(P <0.05)。观察组与对照组术后1周、末次随访时疼痛VAS评分、JOA评分、ODI指数比较差异无统计学意义(P>0.05)。结论骨水泥强化椎弓根钉内固定治疗老年退行性腰椎管狭窄症在缓解患者疼痛、改善脊柱功能的同时可以维持更加稳定的脊柱状态,降低椎弓根钉松动、退出的发生率。
引文
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[10]Liu Y,Xu J,Sun D,et al.Biomechanical and finite element analyses of bone cement-injectable cannulated pedicle screw fixation in osteoporotic bone[J].J Biomed Mater Res B Appl Biomater,2016,104(5):960-967.
[11]Park CK,Park CK,Lee DC,et al.A new technique of bone cement augmentation via the disc space for percutaneous pedicle screw fixation[J].J Neurosurg Spine,2016,24(1):16-19.
[12]Fan HT,Zhang RJ,Shen CL,et al.The biomechanical properties of pedicle screw fixation combined with trajectory bone cement augmentation in osteoporotic vertebrae[J].Clin Spine Surg,2016,29(2):78-85.
[2]黄开,杨金华.后入路双侧减压结合对侧椎旁肌间隙入路治疗双侧神经症状性腰椎管狭窄症[J].中国骨与关节损伤杂志,2016,31(9):974-976.
[3]陈冠军,陈扬,庄汝杰.可灌注骨水泥椎弓根螺钉系统在老年腰椎疾患手术中的应用[J].中医正骨,2015,27(2):40-42.
[4]荆丹峰,许艺荠,孙太存,等.骨水泥注入中空侧孔椎弓根螺钉内固定骨质疏松性腰椎退变:强化技术要点[J].中国组织工程研究,2014,18(47):7556-7560.
[5]Elder BD,Lo SF,Holmes C,et al.The biomechanics of pedicle screw augmentation with cement[J].Spine J,2015,15(6):1432-1445.
[6]邹海波,绳厚福,李中实,等.骨水泥强化椎弓根钉结合经皮椎体成形术治疗老年性骨质疏松椎体压缩性骨折合并椎管狭窄症[J].颈腰痛杂志,2015,36(2):93-99.
[7]Juvonen T,Nuutinen JP,Koistinen AP,et al.Biomechanical evaluation of bone screw fixation with a novel bone cement[J].Biomed Eng Online,2015,14(1):74.
[8]成业东,高超,王加波,等.经椎弓根注入万古霉素骨水泥强化椎弓根螺钉固定椎间隙融合治疗老年人腰椎管狭窄症[J].中华解剖与临床杂志,2017,22(5):419-422.
[9]孙治国,王浩,赵喜滨,等.骨水泥强化椎弓根螺钉固定治疗伴骨质疏松腰椎管狭窄症临床应用[J].中国骨与关节杂志,2015,4(5):388-391.
[10]Liu Y,Xu J,Sun D,et al.Biomechanical and finite element analyses of bone cement-injectable cannulated pedicle screw fixation in osteoporotic bone[J].J Biomed Mater Res B Appl Biomater,2016,104(5):960-967.
[11]Park CK,Park CK,Lee DC,et al.A new technique of bone cement augmentation via the disc space for percutaneous pedicle screw fixation[J].J Neurosurg Spine,2016,24(1):16-19.
[12]Fan HT,Zhang RJ,Shen CL,et al.The biomechanical properties of pedicle screw fixation combined with trajectory bone cement augmentation in osteoporotic vertebrae[J].Clin Spine Surg,2016,29(2):78-85.