组合式椎间处理器辅助下椎间融合术应用研究
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山东省潍坊市人民医院

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潍坊市卫健委科研项目


The Application of Lumbar Interbody Fusion Assisted by the Self-designed Intervertebral Processors
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1.Weifang People'2.'3.s Hospital

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    摘要:

    目的 介绍应用组合式椎间处理器并“自体棘突椎板关节突骨块”的椎间融合技术治疗峡部裂型腰椎滑脱症的手术技术与初步临床疗效。 方法 2014年1月~2019年1月,对157例峡部裂型腰椎滑脱症患者应用组合式椎间处理器并“自体棘突椎板关节突骨块”的椎间融合技术治疗。术中将腰椎峡部裂节段的棘突椎板关节突骨块完整剥离,整块取下备用。应用自行设计的“组合式椎间处理器”螺纹化处理椎间隙上下终板,将完整剥离的棘突椎板关节突骨块,根据目标间隙椎间高度修整成类似融合器外观,行椎间打压植骨融合。安装适当长度预弯连接棒,C臂透视确认滑脱复位满意,固定钉棒。采用 Oswestry 功能障碍指数评分 (ODI) 评价疗效,通过影像学评估椎体间融合情况。结果 所有患者均成功实施手术,手术时间(139.24±35.36)min;术中出血量(275.13±93.22)ml,未出现神经根损伤,术后1周内、3个月、6个月、12个月及末次随访行腰椎X线片或CT检查,评价植骨融合情况及内固定是否存在松动、脱出、断裂等并发症。截至末次随访时所有患者均获得骨性融合,未见内固定松动、脱出、断裂。结论 应用组合式椎间处理器并“自体棘突椎板关节突骨块”的椎间融合技术治疗峡部裂型腰椎滑脱症,术后植骨融合率高,内固定并发症发生率低,疗效确切。

    Abstract:

    Objective:To introduce the surgical technique and preliminary clinical results of the lumbar interbody fusion for treatment of isthmic spondylolisthesis by using the Self-designed intervertebral processors and “Autologous Cage” developed by the autologous spinous, lamina and articular process.Methods:From January 2014 to January 2019,a total of 175 patients with isthmic spondylolisthesis were treated by using the Self-designed intervertebral processor and “Autologous Cage”.During the operation, spinous, lamina and articular process of the diseased segment were completely stripped and removed. The Self-designed intervertebral processor was used to processing the intervertebral disc. And then,autologous spinous, lamina and articular process was trimmed to the appropriate shape bone cage depending to the intervertebral height. After implanting bone, the pre-bent connecting rod of appropriate length were installed and fixed with satisfactory slipped reduction confirmed by C-arm.The Oswestry dysfunction index score (ODI) was used to evaluate the efficacy, and the interbody fusion was evaluated by imaging. Results:All patients were successfully operated. The operation time was (139.24±35.36) min,and the intraoperative blood loss was (275.13±93.22) ml. There was no nerve root injury. To evaluate the effect of interbody fusion and make it clear whether the internal fixation had loosening, prolapse, breakage and other complications, X-ray or CT examinations were performed within 1 week, 3 months, 6 months, 12 months and the last follow-up after operation. At the last follow-up, all patients had satisfactory curative effects with no internal fixation loosening, prolapse, or breakage.Conclusion:Using the Self-designed intervertebral processor and “Autologous Cage”to treat isthmic spondylolisthesis can achieve high bone graft fusion rate,lower incidence of internal fixation complications.

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  • 收稿日期:2020-12-27
  • 最后修改日期:2020-12-27
  • 录用日期:2021-01-28
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