摘要
目的 探讨椎间融合器植入术与单纯椎间植骨术治疗腰椎退行性疾患对椎间隙高度丢失的影响。方法 24例共35个腰椎节段接受椎间融合手术，其中18个间隙实施椎间盘摘除，单纯椎间植骨；17个间隙实施椎间盘摘除后椎间融合器植入术。共置入融合器26枚（双枚植入9例，单枚植入8例）。摄X线片测量施术节段椎间隙高度变化，进行比较研究。结果 随访18—24个月，单纯植骨组椎间隙高度丢失主要出现在术后3～6个月，丢失率为24．80％；而椎间融合器组的椎间隙高度早期丢失较少，丢失率为18．65％。结论单纯椎间植骨和椎间融合器植入术各有特点，前者手术费用低，但患者下地负重时间较迟，在术后近期应加强保护，以减少椎间隙高度的丢失；后者术后即刻稳定性好，可以早期下地负重，但对于骨质疏松患者应该慎重选择，必要时在积极治疗骨质疏松的基础上选择大接触面的低应力融合器，以降低应力集中引起的迟发性融合器下沉。
Objective To investigate the effect of interbody fusion with or without cage on the loss of intervertebral height. Methods 24 cases （35 segments） were undergone interbody fusion, of which 18 spaces were performed with single bone graft, while 17 with cage interbody fusion after discectomy. 26 cages were used （2 for each segment in 9 spaces, 1 for each segment in 8 spaces）. The intervertebral heights were measured by roentgenograph and compared. Results All cases were followed up for 18-24 months. The loss of intervertebral height occurred in 3 - 6months postoperatively in single bone graft group, and the loss rate was 24. 80%. The loss rate was 18.65% in cage group. Conclusions The 2 methods for interbody fusion have characteristics. The former is less costly, but requires longer non-weight bearing and protection. The latter can provide immediate stability, which can permit early weight bearing. However, caution must be taken for those with osteoperosis. Lower stress cage with larger contact area can be used if necessary after active treatment of osteoperosis.
出处
《临床骨科杂志》
2006年第6期484-486,共3页
Journal of Clinical Orthopaedics
基金
广州市科技计划基金项目(编号:2004Z3-E0211)
关键词
脊柱融合术
椎间隙高度丢失
spinal fusion
intervertebral altitude loss
作者简介
王建华，男，主治医师，主要从事脊柱外科研究。
