经椎间孔椎体间融合两种骨移植方式的比较
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1.海军军医大学第一附属医院脊柱外科;2.陕西省西安市西安大兴医院

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海军军医大学第一附属医院“234”攀峰计划临床学科创新项目


Comparison of two bone graft methods for transforaminal lumbar interbody fusion
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1.] Department of spine surgery, the first affiliate hospital of navy medical university;2.xi an da xing hospital

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    摘要:

    目的:探讨新型植骨管植骨在腰椎体间融合术中的安全性和有效性。方法:回顾分析2018年9月-2019年8月应用新型植骨管植骨和传统漏斗植骨联合椎间融合器植骨119例,其中新型植骨管植骨组(新型组,61例)、传统漏斗植骨组(传统组,58例)。分别对两组患者住院资料和术后临床和影像学随访资料进行比较分析。结果:所有患者均获1年以上随访。两组间的手术时间、术中出血量、术后引流量及下地行走时间等差异无统计学意义(P>0.05)。新型组植骨时间明显快于传统组,差异有统计学意义(P<0.05)。术中均未出现神经、硬膜损伤,术后未发生感染,传统组出现骨粒漏至神经根周围2例,保守治疗后症状缓解未行手术治疗。腰痛VAS评分、JOA、ODI和影像学指标术后均较术前明显改善,差异有统计学意义(P<0.05)。末次随访时两组均获骨性融合,无内植物并发症。结论:应用新型植骨管植骨联合椎间融合器植骨可以安全、高效地完成腰椎后路椎间融合术。与传统漏斗植骨联合椎间融合器植骨相比,新型植骨管植骨具有植骨效率高、安全等优点,可在临床上加以推广应用。

    Abstract:

    Objective: To investigate the safety and effectiveness of new bone graft method in lumbar interbody fusion. Methods: A retrospective analysis was conducted on 119 cases of bone graft with new bone graft tube and traditional funnel bone graft combined with Cage from September 2018 to August 2019, new bone graft tube group (61 cases) and traditional funnel bone graft group (58 cases). The hospitalization data and postoperative clinical and imaging follow-up of the two groups were compared and analyzed. Results: All patients were followed up for more than 1 year. There was no significant difference in operation time, intraoperative blood loss, postoperative drainage volume and walking time between the two groups (P>0.05). The bone graft time of the new group was significantly faster than that of the traditional group, and the difference was statistically significant (P<0.05). There was no nerve and dura mater injury during the operation, and no infection occurred after operation. In the traditional group, there were 2 cases of bone leakage around the nerve root. After conservative treatment, the symptoms were relieved without surgical treatment. The VAS score, JOA, ODI and imaging indexes of lumbar spine were significantly improved after operation, and the differences were statistically significant (P<0.05). Bone fusion was achieved in both groups at the final follow-up. Conclusion: The application of new bone graft tube combined with cage bone graft can safely and efficiently complete lumbar posterior interbody fusion. Compared with the traditional funnel bone graft combined with intervertebral fusion cage, the new bone graft has the advantages of high efficiency and safety, which can be popularized and applied in clinic.

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  • 收稿日期:2021-10-19
  • 最后修改日期:2022-01-12
  • 录用日期:2022-05-11
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