应用可撑开融合器B-twin治疗腰椎不稳症的疗效观察

Clinical outcomes of B-Twin expandable intervertebral cage in the treatment of lumbar spinal instability syndrome

中文关键词:  腰椎  椎间融合器  脊柱融合术  腰椎不稳症

英文关键词:Lumbar  Intervertebral cage  Spinal fusion  Lumbar spinal instability syndrome

中文摘要:

  【摘要】 目的：探讨应用可撑开融合器B-twin治疗腰椎不稳症的临床疗效和价值。方法：回顾性分析2006年3月～2009年6月我科收治的52例腰椎退变性不稳症患者，采用B-twin融合器进行后路椎间融合手术，共融合52例56个椎间隙。对所有病例术前、术后复诊时的JOA评分、椎间隙高度及融合情况进行评价。结果：随访时间8～18个月，平均12个月，52例患者术前JOA评分5～9分，平均7分，术后１周JOA评分15～22分，平均19分，末次随访19～26分，平均22分，术后、末次随诊与术前比较JOA评分差异有显著性（P<0.01）。其中显效36例，有效12例，无效4例，显效率69.23％。术前椎间高度7.5～11mm，平均8.0mm，术后9.5～13mm，平均11.5mm，末次随诊9.0～12.5mm，平均11mm，术后、末次随诊与术前比较椎间高度差异有显著性 （P<0.05）；动力位X线片显示腰椎融合率78.６％，B-twin下沉率21.２%，未发现B-twin移位。结论：B-twin融合器用于治疗腰椎不稳症短期疗效确切，需警惕假体下沉、腰背部僵硬等并发症发生。

英文摘要:

  【Abstract】 Objective：To investigate the clinical outcomes of B-Twin expandable intervertebral cage in the treatment of lumbar spinal instability．Method：From March 2006 to June 2009，a total of 56 disks in 52 patients with degenerative lumbar spinal instability underwent PLIF operation using B-Twin intervertebral cage．The JOA score，intervertebral height and fusion status for all cases pre- and post-operatively were reviewed retrospectively．Result：All cases were followed up for an average of 12 months（range，8-18 months），the mean preoperative JOA score of 52 cases was 7（range，5-9），while 19 （range，15-22） at 1 week postoperatively and 22（range，19-26）at final follow-up，which showed significant difference（P<0.01）．Clinical outcomes were excellent in 36 cases，good in 12 cases and no effect in 4 cases，with the excellent rate of 69.3%．The preoperative intervertebral height was 8.0mm on average（range，7.5-11mm），while 11.5mm （range，9.5～13mm ）at 1 week postoperatively and 11mm （range，9.0～12.5mm ）at final follow-up，which showed significant difference（P<0.01）．The fusion rate was 78.6% on dynamic radiograph，and the B-twin subsidence rate was 21.2%，and no B-twin displacement was noted．Conclusion:The short-term outcomes of B-twin for lumbar spinal instability is reliable，but prosthesis subsidence and low back stiff should be taken into account.