自体下关节突股块与Cage椎体间融合效果比较

两种椎间植骨融合方式治疗腰椎滑脱的临床疗效的分析

目的:探讨两种椎间植骨融合方式治疗腰椎滑脱的临床疗效.方法:选取我院2015年12月～2016年12月腰椎滑脱症患者80例,分A组与B组,各40例,对A组给予单纯自体骨植骨融合,对B组给予椎间融合器(Cage)融合,然后比较两组患者的手术时间、术中出血量、滑脱复位率和复位丢失率.结果:B在手术时间及术中出血量方面A组优于B组,显著差异有统计学意义(P<0.05),两组术前和术后的JOA评分比较差异不显著,且无统计学意义(P>0.05),两组患者在术后1个月的滑脱复位率有可比性,但无统计学意义(P>0.05),终末复位丢失率比较存在巨大差异,有统计学意义(P<0.05).结论:两种椎间植骨融合方式都具有良好的治疗效果,应用时要根据患者的身体情况选择合适的椎间植骨融合方式

Posterior lumbar inter-body fusion (PLIF) using autogenous bone and cage with pedicle screw instrumentation versus PLIF using cage with pedicle screw instrumentation in adult spondylolisthesis

Objective: To compare the clinical outcomes of PLIF using autogenous bone and cage with pedicle screw fixation (group 2) and simple cage fusion with pedicle screw fixation (group 1) in adult spondylolisthesis.Methods: 27 patients with minimum follow-up of 24 months, treated by inter-body fusion with pedicle screw fixation were prospectively studied. Disc space height, degree of slippage and fusion rate had been compared before and after operation between the two groups. Results: After minimum 24 month's follow-up, there was no significant difference between the two groups in terms of the amount of blood loss, duration of hospital stay, back pain,radiating pain, fusion rate, or complication (P＞0.05). however, there was a significant difference between the two groups in terms of disc space height and percentage of slippage (P＜0.05). Conclusion: PLIF using autogenous bone and cage with pedicle screw fixation more beneifical to improve fusion rate and prevent long-term instabilities than simple cage fusion with pedicle screw fixation in adult spondylolisthesis.

Cage＋异体骨与自体髂骨植骨融合在单节段颈椎间盘突出症手术治疗中的疗效比较

目的：探讨在单节段颈椎间盘突出症手术中Cage ＋同种异体骨植骨与自体髂骨植骨这两种术式疗效之间的差异。方法对42例单节段颈椎间盘突出症患者分为A、B两组，行颈椎前路椎间盘切除，椎管减压，椎间植骨融合内固定术。 A组22例病人选择行Cage ＋同种异体骨植入术，B组20例病人行取自体髂骨植入术。对比两组患者手术出血量、手术时间、术后并发症、椎间高度、JOA评分、症状改善率、融合率情况并分析两种术式的疗效差异。结果 A组在手术出血量和手术时间方面明显少于B组，差异有显著意义（P＜0．01）。 A组患者较 B组患者术后并发症少。两组术后6个月JOA评分及症状改善率无显著性差异（P＞0．05），融合节段椎间高度术前术后有显著差异（P ＜0．01）。在术后3个月、6个月及12个月时两组融合率差异无显著性意义（P＞0．05）。结论与自体髂骨相比，Cage ＋同种异体骨在治疗单节段颈椎间盘突出症中疗效满意，且创伤更小，没有取髂骨带来的疼痛和吞咽困难等并发症，是治疗单节段颈椎间盘突出症较为理想的术式之一。