后路椎间融合及经椎间孔入路椎间融合治疗伴椎弓断裂的退变性腰椎滑脱症的临床效果比较

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1、后路椎间融合及经椎间孔入路椎间融合治疗伴椎弓断裂的退变性腰椎滑脱症的临床效果比较［摘要］目的探讨后路椎间融合及经椎间孔入路椎间融合治疗伴椎弓断裂的退变性腰椎滑脱症的临床疗效。方法回令性分析2011年1月〜2015年12月东台市人民医院骨科收治的120例伴椎弓断裂的退变性腰椎滑脱症患者的临床资料，按手术方法不同分为两组，其中60例采用后路椎间融合为对照组，60例采用经椎间孔入路椎间融合为观察组。比较两组手术时间、住院费用、术中出血量；术后随访1年，比较两组JOA评分，定期复查X线片，观察融合情况及腰椎稳定性。结果观察组手术时间、术中出血量和住院费用均低于对照组，差异有统计学意义。两组术后OD指

2、数均低于术前，且观察组低于对照组，差异有统计学意义。两组融合率差异无统计学意义。两组随访期间椎体活动度和透亮带宽度差异无统计学意义，而椎间隙平均高度对照组低于观组，差异有统计学意义。对照组2例出现脑脊液漏，与术中分离瘢痕粘连有关，术后予头低脚高位，症状缓解。随访期间未出现无融合器移位、下沉及钉棒松动、断裂发生。两组均未出现感染。结论经椎间孔入路椎间融合在伴有椎弓峡部裂的腰椎滑脱症患者中创伤小、复位理想、临床疗效满意，腰椎稳定性好，骨性融合率高，值得临床推广应用。［关键词］椎间融合；椎间孔；椎弓断裂；腰椎滑脱症［中图分类号］R687.3［文献标识码］A［文章编号］1673-721006-009

3、4-04［Abstract］ObjectiveToinvestigatetheclinicaleffectofposteriorinterbodyfusionandintervertebralforamenfusioninthetreatmentofdegenerativelumbarspondylolisthesiswithvertebralfracture.MethodsFromJanuary2011toDecember2015，inDepartmentofOrthopedics，DongtaiPeople’sHospital，theclinicaldataof120patientswi

4、thvertebralfracturedegenerationlumbarspondylolisthesiswereanalyzedretrospectively,accordingtotheoperationmethodtheyweredividedintoobservationgroupandcontrolgroup，60caseswithposteriorinterbodyfusionwereascontrolgroup，and60caseswithintervertebralforemenfusionwereasobservationgroup.Theoperativetime，ho

5、spitalizationcostandintraoperativebloodlossofthetwogroupswerecompared.1yearafteroperation,theJOAscoreswerecompared，theX-rayfilmswereregularlyreviewedtoobservethefusionandlumbarstability.ResultsTheoperationtime，intraoperativebloodlossandhospitalizationcostwereintheobservationgrouplowerthanthoseinthe

6、controlgroup，thedifferenceswerestatisticallysignificant.TheODIoftheobservationgroupwaslowerthanthatofthecontrolgroup，thedifferencewasstatisticallysignificant.Therewasnosignificantdifferenceoffusionratebetweenthetwogroups.Therewasnosignificantdifferenceinvertebralactivityandtranslucentbandwidthbetwe

7、enthetwogroups，buttheaverageheightoftheintervertebralspaceofcontrolgroupwaslowerthanthatoftheobservationgroup，thedifferencewasstatisticallysignificant.Inthecontrolgroup，therewere2casesofcerebrospinalfluidle