Cage加压与否对腰椎退变性疾病行PLIF手术疗效的影响
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摘要
目的探讨Cage加压与否对腰椎退变性疾病行PLIF手术疗效的影响。方法选取2014-01-2016-01,我院行PLIF手术治疗的单节段腰椎退行性疾病患者60例,采用随机数字表法分为两组:对照组30例,术中均予以Cage加压固定处理;观察组30例,术中不予以Cage加压固定。对两组患者随访期间的疗效指标进行比较。结果 (1)相较于对照组,观察组术后3个月和末次随访时的椎间隙、腰椎前凸角和椎间孔高度改善均更为显著,差异有统计学意义(P<0.05);(2)两组术后6个月、1年和2年的腰椎融合率差异无统计学意义(P>0.05);(3)两组患者行PLIF术后3个月和末次随访时,VAS评分、ODI指数和SF-36评分均有显著改善(P<0.05),但组间差异无统计学意义(P>0.05)。(4)相关性分析显示,两组椎间隙和椎间孔高度增加与VAS评分、ODI指数和SF-36评分的改善无明显相关性(P>0.05)。结论在PLIF手术中无论Cage加压与否,对Cage稳定性和融合率均无明显影响;Cage不加压更利于保持术后患者机体椎间隙和椎间孔高度,但与PLIF手术疗效无明显相关性。
Objective To investigate the effect of Cage on lumbar degenerative disease treated with PLIF. Methods 60 patients with single-segment lumbar degenerative disease who underwent PLIF from January 2014 to January 2016 were divided into two groups by random number table method: 30 patients in control group were treated with Cage compression and fixation during operation; the control group(30 cases) was treated with Cage compression fixation during operation, while the observation group(30 cases) was not treated with Cage compression fixation during operation. The efficacy indicators of the two groups during follow-up period were compared. Results (1) Compared with the control group, the improvement of intervertebral space, lumbar lordosis angle and intervertebral foramen height was more significant in the observation group at 3 months after operation and at the last follow-up(P<0.05);(2) There was no significant difference in lumbar fusion rate between the two groups at 6 months, 1 year and 2 years after operation(P>0.05);(3) VAS score, ODI index and SF-36 score were significantly improved in both groups at 3 months after PLIF and at the last follow-up(P<0.05), but there was no significant difference between the two groups(P>0.05).(4) Correlation analysis showed that the increase of intervertebral space and foramen height had no significant correlation with the improvement of VAS score, ODI index and SF-36 score(P>0.05). Conclusion The stability and fusion rate of age were not significantly affected by compression fixation or not during PLIF.Cage is not pressurized to maintain the height of intervertebral space and foramen intervertebralis in patients after PLIF, but it has no significant correlation with the curative effect of PLIF.
Objective To investigate the effect of Cage on lumbar degenerative disease treated with PLIF. Methods 60 patients with single-segment lumbar degenerative disease who underwent PLIF from January 2014 to January 2016 were divided into two groups by random number table method: 30 patients in control group were treated with Cage compression and fixation during operation; the control group(30 cases) was treated with Cage compression fixation during operation, while the observation group(30 cases) was not treated with Cage compression fixation during operation. The efficacy indicators of the two groups during follow-up period were compared. Results (1) Compared with the control group, the improvement of intervertebral space, lumbar lordosis angle and intervertebral foramen height was more significant in the observation group at 3 months after operation and at the last follow-up(P<0.05);(2) There was no significant difference in lumbar fusion rate between the two groups at 6 months, 1 year and 2 years after operation(P>0.05);(3) VAS score, ODI index and SF-36 score were significantly improved in both groups at 3 months after PLIF and at the last follow-up(P<0.05), but there was no significant difference between the two groups(P>0.05).(4) Correlation analysis showed that the increase of intervertebral space and foramen height had no significant correlation with the improvement of VAS score, ODI index and SF-36 score(P>0.05). Conclusion The stability and fusion rate of age were not significantly affected by compression fixation or not during PLIF.Cage is not pressurized to maintain the height of intervertebral space and foramen intervertebralis in patients after PLIF, but it has no significant correlation with the curative effect of PLIF.
引文
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[2]郑剑平,赖伟强,孙春汉,等.改良TLIF技术与PLIF手术治疗腰椎管狭窄症的临床疗效比较[J].中国伤残医学,2017,25(9):47-48.
[3]万仲贤,陈泽,李强. PLIF手术对退变性腰椎滑脱症脊柱骨盆参数影响及疗效分析[J].颈腰痛杂志,2016,37(05):416-420.
[4] Kim SI, Ha KY, Kim YH, et al.A Comparative Study of Decompressive Laminectomy and Posterior Lumbar Interbody Fusion in Grade I Degenerative Lumbar Spondylolisthesis[J]. Indian J Orthop,2018,52(4):358-362.
[5]席焱海,王洋,余将明,等.应用皮质骨轨迹螺钉联合椎弓根螺钉内固定技术治疗老年骨质疏松腰椎退变性疾病的临床疗效[J].第二军医大学学报,2016,37(07):879-883.
[6]柳扬,张怀华,范磊,等. PLIF围手术期隐性失血相关影响因素初步分析[J].实用骨科杂志,2016,22(06):496-498.
[7]荣树,张平荣,吴峥,等. MI-TLIF与传统PLIF手术治疗单节段腰椎管狭窄症的疗效比较[J].中国骨与关节损伤杂志,2016,31(S1):11-13.
[8] Inanami H, Saiki F, Oshima Y. Microendoscope-assisted posterior lumbar interbody fusion:a technical note[J]. J Spine Surg,2018,4(2):408-413.
[9] Kimura H, Shikata J, Odate S, et al. Risk factors forcage retropulsion after posterior lumbar interbodyfusion:analysis of 1070cases. Spine. 2012;37(13):1164-1169.
[10] Chen L, Yang H, Tang T. Cage migration inspondylolisthesis treated with posterior lumbar interbodyfusion using BAK cages.Spine. 2005;30(19):2171-2175.
[11]邓乾兴.腰椎椎间融合术后融合器下沉的研究进展[J].广东医学,2017,38(04):644-647.
[2]郑剑平,赖伟强,孙春汉,等.改良TLIF技术与PLIF手术治疗腰椎管狭窄症的临床疗效比较[J].中国伤残医学,2017,25(9):47-48.
[3]万仲贤,陈泽,李强. PLIF手术对退变性腰椎滑脱症脊柱骨盆参数影响及疗效分析[J].颈腰痛杂志,2016,37(05):416-420.
[4] Kim SI, Ha KY, Kim YH, et al.A Comparative Study of Decompressive Laminectomy and Posterior Lumbar Interbody Fusion in Grade I Degenerative Lumbar Spondylolisthesis[J]. Indian J Orthop,2018,52(4):358-362.
[5]席焱海,王洋,余将明,等.应用皮质骨轨迹螺钉联合椎弓根螺钉内固定技术治疗老年骨质疏松腰椎退变性疾病的临床疗效[J].第二军医大学学报,2016,37(07):879-883.
[6]柳扬,张怀华,范磊,等. PLIF围手术期隐性失血相关影响因素初步分析[J].实用骨科杂志,2016,22(06):496-498.
[7]荣树,张平荣,吴峥,等. MI-TLIF与传统PLIF手术治疗单节段腰椎管狭窄症的疗效比较[J].中国骨与关节损伤杂志,2016,31(S1):11-13.
[8] Inanami H, Saiki F, Oshima Y. Microendoscope-assisted posterior lumbar interbody fusion:a technical note[J]. J Spine Surg,2018,4(2):408-413.
[9] Kimura H, Shikata J, Odate S, et al. Risk factors forcage retropulsion after posterior lumbar interbodyfusion:analysis of 1070cases. Spine. 2012;37(13):1164-1169.
[10] Chen L, Yang H, Tang T. Cage migration inspondylolisthesis treated with posterior lumbar interbodyfusion using BAK cages.Spine. 2005;30(19):2171-2175.
[11]邓乾兴.腰椎椎间融合术后融合器下沉的研究进展[J].广东医学,2017,38(04):644-647.