| 白露露,王剑锋,王文涛,等.椎体间融合术结合单枚或双枚椎间融合器治疗双侧峡部裂型Ⅱ度腰椎滑脱症的对比研究.骨科,2021,12(4): 300-305. |
| 椎体间融合术结合单枚或双枚椎间融合器治疗双侧峡部裂型Ⅱ度腰椎滑脱症的对比研究 |
| Efficacy of Posterior Lumbar Interbody Fusion Combined with One versus Two Cages for Treatment of Bilateral Isthmic Ⅱ Degree Spondylolisthesis |
| 投稿时间：2020-09-30 |
| DOI：10.3969/j.issn.1674-8573.2021.04.002 |
| 中文关键词: 峡部裂型腰椎滑脱症 椎体间融合术 椎间融合器 |
| 英文关键词: Isthmic spondylolisthesis Posterior lumbar interbody fusion Cage |
| 基金项目:国家自然科学基金重点项目（81830077） |
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| 中文摘要: |
| 目的 对比椎体间融合术（posterior lumbar interbody fusion，PLIF）结合单枚或双枚椎间融合器治疗双侧峡部裂型Ⅱ度腰椎滑脱症的临床效果。方法 回顾性收集2017年1月至2017年12月在西安交通大学医学院附属红会医院脊柱病院接受PLIF手术治疗双侧峡部裂型Ⅱ度腰椎滑脱症的172例病人的临床资料，根据椎间融合器的数量，将病人分为单枚组（97例）和双枚组（75例）。采用疼痛视觉模拟量表（visual analogue scale，VAS）、Oswestry功能障碍指数（oswestry disability index，ODI）问卷表、健康调查简表（the Medical Outcomes Study 36-item short-form health survey，SF-36）等功能评分及腰椎滑脱率、椎间隙高度、腰椎生理前凸角、椎间融合率等影像学指标来评估两组病人的临床效果。结果 单枚组随访24~36个月，平均29.7个月；双枚组随访24~36个月，平均28.8个月。与单枚组相比，双枚组的手术时间明显延长，术中出血量显著增多。所有病人术后及末次随访时的VAS评分、ODI、SF-36评分、腰椎滑脱率、椎间隙高度、腰椎生理前凸角均较术前有明显改善，差异有统计学意义（P＜0.05），但组间比较，差异无统计学意义（P＞0.05）。末次随访时，双枚组的椎间融合率较单枚组高，但两组差异无统计学意义（P＞0.05）。结论 PLIF结合单枚或双枚椎间融合器治疗双侧峡部裂型Ⅱ度腰椎滑脱症均可取得良好的临床结果，但单枚组较双枚组具有手术时间短、手术创伤小及术中出血量少等优势。 |
| 英文摘要: |
| Objective To compare the clinical curative effect of posterior lumbar interbody fusion (PLIF) combined with one versus two cages for treatment of bilateral isthmic Ⅱ degree spondylolisthesis. Methods From January 2017 to December 2017, 172 patients with bilateral isthmic Ⅱ degree spondylolisthesis treated by PLIF were analyzed retrospectively. A total of 97 patients (one-cage group) were treated by PLIF combined with one cage, and the rest (two-cage group) were treated by PLIF combined with two cages. The visual analogue scale (VAS), Oswestry disability index (ODI), the Medical Outcomes Study 36-Item short-form health survey (SF-36), as well as lumbar spondylolisthesis rate, average height of intervertebral space, lumbar physiological kyphosis angle and interbody fusion rate were recorded and compared between the two groups. Results The patients in one-cage group were followed up for 29.7 months (from 24 to 36 months), and patients in two-cage group were followed up for 28.8 months (from 24 to 36 months). Except for the operative time, blood loss (P＜0.05), there was no significant difference in the baseline data between the two groups. The VAS scores, ODI scores, SF-36 scores, lumbar spondylolisthesis rate, average height of intervertebral space and lumbar physiological kyphosis angle were significantly different from those preoperation in both groups (P＜0.05), but there was no significant difference between the two groups (P＞0.05). Further analysis showed that the interbody fusion rate in the two-cage group was higher than that in the one-cage group at the last follow-up, but there was no statistically significant difference between the two groups (P＞0.05). Conclusion PLIF combined with one or two cages can achieve great clinical results for treatment of bilateral isthmic Ⅱ degree spondylolisthesis, but one cage has the advantages of short operative time, less trauma and less blood loss. |
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