Zhang Jian-Qiao, Dong Li-Qiang, Jin Cai-Yi, Zeng Zhong-You, Hang Jian-Fu, Xiang Jun
Department of the 2nd Orthopaedics, the Hospital of Zhejiang Armed Police Force, Jiaxing 314000, Zhejiang, China.
Zhongguo Gu Shang. 2009 Oct;22(10):733-7.
To compare the clinical and radiologic effect in treating degenerative lumbar instability with single or double carbon fiber cages.
From November 2005 to October 2006, 97 patients of degenerative lumbar instability were followed up more than two years. All cases underwent pedicle screw fixation. Meanwhile, 41 of them, named group A, were applied with single carbon fiber cage, with 23 males and 18 females, aged for 35-70 years, including 38 cases with single vertebral instability and 3 cases with existing L4.5 and L5S1 intervertebral instability. The other 56 cases, named group B, were treated with two carbon fiber cages, with 32 males and 24 females, aged for 33-72 years, including 53 cases with single vertebral instability and 3 cases existing L4.5 and L5S1 intervertebral instability. The clinical effect, intervertebral fusion ratio and lost intervertebral height were compared between two groups.
All patients were followed up for 24-35 months, with an average of 28 months. Clinical effects (including symptom, sign, daily action and bladder function) were evaluated according to JOA 29 score. In group A: the JOA score improve from 10.11 +/- 2.40 preoperative to 24.88 +/- 2.30 at final follow-up, 25 cases obtained excellent results, 12 good, 4 fair; 39 cases obtained fusion with the fusion ratio of 95.1% (39/41). In group B: the JOA score from 9.62 +/- 2.60 preoperative to 25.19 +/- 2.40 at final follow-up, 37 cases obtained excellent results, 13 good, 6 fair; 53 cases obtained fusion with the fusion ratio of 94.6% (53/56). In the 7th day after operation, the average intervertebral height in group A was (11.2 +/- 1.2) mm,and that of group B was (11.3 +/- 1.4) mm. Two years later, the average intervertebral height in group A was (11.0 +/- 1.4) mm, while that of group B was (11.1 +/- 1.4) mm. There was no significant difference between two groups in clinical effect, intervertebral fusion ratio and lost intervertebral height (P > 0.05).
Pedicle screw fixation and single or double carbon fiber cages in treating degenerative lumbar instability both can obtain satisfactory curative effect. Single carbon fiber cage has advantages such as minimally trauma, simply operation, retentively posterior column structure, cheaply price than double carbon fiber cages.
比较单枚与双枚碳纤维椎间融合器治疗退变性腰椎不稳的临床及影像学效果。
2005年11月至2006年10月，对97例退变性腰椎不稳患者进行了2年以上随访。所有病例均行椎弓根螺钉内固定。其中41例为A组，应用单枚碳纤维椎间融合器，男23例，女18例，年龄35 - 70岁，其中单节段椎体不稳38例，合并L4.5、L5S1节段不稳3例。另外56例为B组，应用双枚碳纤维椎间融合器，男32例，女24例，年龄33 - 72岁，其中单节段椎体不稳53例，合并L4.5、L5S1节段不稳3例。比较两组的临床疗效、椎间融合率及椎间高度丢失情况。
所有患者随访24 - 35个月，平均28个月。根据JOA 29分法评估临床疗效（包括症状、体征、日常活动及膀胱功能）。A组：术前JOA评分为10.11±2.40，末次随访时为24.88±2.30，优25例，良12例，可4例；39例获得融合，融合率为95.1%（39/41）。B组：术前JOA评分为9.62±2.60，末次随访时为25.19±2.40，优37例，良13例，可6例；53例获得融合，融合率为94.6%（53/56）。术后第7天，A组椎间平均高度为（11.2±1.2）mm，B组为（11.3±1.4）mm。术后2年，A组椎间平均高度为（11.0±1.4）mm，B组为（11.1±1.4）mm。两组在临床疗效、椎间融合率及椎间高度丢失方面差异无统计学意义（P＞0.05）。
椎弓根螺钉内固定联合单枚或双枚碳纤维椎间融合器治疗退变性腰椎不稳均能获得满意疗效。单枚碳纤维椎间融合器具有创伤小、操作简单、能保留后柱结构、价格比双枚碳纤维椎间融合器便宜等优点。
