自锁稳定型椎间融合器前路融合术治疗退变性腰椎疾病的效果观察.doc

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1、自锁稳定型椎间融合器前路融合术治疗退变性腰椎疾病的效果观察［摘要］目的探讨自锁稳定型椎间融合器前路融合术治疗退变性腰椎疾病的效果。方法选取2012年6月〜2014年10月在我院就诊并治疗的单节段腰椎滑脱患者共46例。随机分为两组，各23例，分别进行经腹直肌旁小切口腹膜外间隙入路后自锁稳定型椎间融合器治疗术(AIJF)和传统的腰椎后路椎间融合术(PLIF)O记录患者术前、术后的症状和体征、术后的并发症及术后定期复查并评价植骨融合情况。采用日本骨科学会下腰痛评分系统(J0A评分)进行统计分析。结果ALIF组在术后J0A改善率为85.79%,并发症发生率为13.04%,均优于

2、PLIF组。两组术后J0A评分比较，差异有统计学意义(P<0.01)o结论在治疗腰椎退变性疾病时AIJF具有创伤小、术后临床效果好，患者恢复较快，并发症及后遗症少等优点,避免了腰椎后方结构的破坏，是…种新的微创外科手术方式。［关键词］腰椎退变性疾病；前路椎间融合术；椎间融合［中图分类号］R274.34［文献标识码］A［文章编号］1674-4721(2016)08(a)-0085-03.Abstract］ObjectiveToinvestigatetheeffectivenessofapplicationofALIF(AnteriorLumbarInterbodyFusi

3、on)withstable-typeself-lockingPCB(PlateCageBenezech)intreatmentofdegenerative1umbardiseases.MethodsAtotalof46patientswithlumbarspondylolisthesistreatedinourhospitalfromJune2012toOctober2014wereselectedandrandomlydividedintotwogroups,with23casesineachgroup.Andthetwogroupsweretreatedwithla

4、teralrectussmallincision,ALTFwithstable-typeseif-lockingPCBafterextraperitonealspaceapproachandconventionalPLIF(PosteriorLumbarInterbodyFusion)respectively.Pre-operativeandpost-operativesymptomsandsignsandpost-operativecomplicationswererecorded；thepost-operativebonegraftfusionwasreviewed

5、andevaluated.TheJOA(JapaneseOrthopaedicAssociation)scoringsystemwasadoptedforstatisticalanalysis.ResultsTheimprovementrateofJOAandtheincideneerateofcomplicationsinALTFgroupwas85.79%and13.04%respectively,whichwasbetterthanthoseofPLIFgroup・Thepost-operativeJOAscoresbetweenthetwogroupsweres

6、tatisticallysignificant(P〈0・01)・ConclusionAsanewminimallyinvasivesurgicalprocedure,AL1Fdemonstratesitsadvantagesoflittletrauma,excellentpost-operativeclinicaleffects,fasterrecovery,lesscomplicationsandsequelaesinthetreatmentoflumbardegenerativediseases,andavoidsthedestructionoftheposteri

7、orstructureofthelumbarspine・[Keywords]Degenemtivelumbardiseases；Anteriorlumbarinterbodyfusion；Tntervertebralfusion退变性腰椎疾病是中老年人群的多发病，给中老年患者的身体健康及生活质量带来严重影响。冃前治疗仍以后路腰椎手术为主，其能起到彻底的减压以及较好的固定作用，临床上取得良好的疗效，但术中对椎旁肌及血管、神经的破坏，往往导致术后并发症较多［1］。Burns等［2］首先报道前路椎间融合术(anteriorlumborinter