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1、经皮椎体间融合术的近期疗效观察郭江陈向荣徐国喜（郑州153医院脊柱外科450052郑州市）【摘要】目的观察可膨胀性椎间融合器B-twin应用在经皮椎体间融合术治疗退行性下腰椎疾患中的近期疗效。方法2006年1月至2008年10月，对32例共35间隙退行性下腰椎疾患患者在后路经皮穿刺行椎间盘切吸B-twin融合器植入椎间融合术。男16例，女16例；年龄31〜77岁，平均57岁。腰椎间盘突出症17例，椎间盘源性腰痛2例，腰椎不稳症13例。手术融合节段：L3,4,5两间隙3例，L3,4间隙3例，L4,5间隙20例，L5S1间隙6
2、例。常规经皮椎间盘髓核切吸后，处理椎体软骨终板。在型臂X线机透视下,选择合适尺寸的可膨胀性椎间融合器B-twin插入椎间隙内，同时行椎间融合器外同种异体骨植骨融合。分别于术前、术后1周、术后3个月、术后12个月进行J0A评分评估临床治疗效果，同时进行X线片及CT检查观察融合器位置及融合情况。结果随访时间5〜38个月（平均18个月），其中5例B-twin椎间融合器位置轻度下沉（20%以内），2例明显下沉（大于20%）,无明显临床症状。根据J0A评分标准评估临床治疗结果：优8例，良17例，可5例，差2例，症状改善优良率达7&1
3、3%o结论经皮椎体间融合术在退变性下腰椎疾患治疗中具有创伤小，恢复快，近期临床效果可靠的优点，严格手术适应症和良好的外科技术是确保疗效的前提。［关键词］腰椎间盘突出症；经皮椎体间融合术；微创；脊柱融合术;B-twinTheshort-termclinicalresultsofpercutaneousintervertebralfusionimplantedwithB-twininthedegenerative1umbardiseases・GuoJiang,Chenxiangrong,XuGuoxi,etal.[Abstra
4、ct]Objective:ToexploretheclinicaloutcomeofpercutaneousintervertebralfusionimplantedwiththeexpandabIespinalspacer(B-twin)inthedegenerativelumbardiseases・Methods:FromJanuary2006toOctober2008,32consecutivepatientswithIumbardegenerativediscdiseasewereincludedand35inte
5、rvertebralspaceswereobservedinthisstudy.Therewere16malesand16females,withaverageageof57years(range31-77years),including17protrusionoflumbardisc,13distabilityoflumbarspineandlumbarbackpainofdiscogenita1.FusionsegementsincludedL3,4,53cases,L3,43cases,L4,520cases,L5S
6、16cases・Afterpercutaneousnucleotomyandendplatecurettageweremeticulouslycarriedout・AB-twinexpandablespinalspacerwasintroducedintotheintervertebralspaceandthenexpandedand3-6gallograftcancellousbonewasimplantedaroundtheB~twinintheintervertebralspace・Thewholeoperation
7、wasmonitoredbyC-armfluoroscopy.TheclinicaloutcomewasevaluatedbyJOAscaleandX-raysandCTexaminationbeforetheoperation,and1week,3monthsand12monthsaftertheoperation.Results:AfterfolIow~upof5to38months(mean18months),Allthepatientswereevaluatedandexcellentin8cases,good17
8、cases,fair5cases,poor2case,theexcellentandgoodratewas78.13%accordingtotheJOAscale・X-raysandCTshowedthatThesubsidencedegreeoftheB-twinwassignificantlymor
