Zhang Haiping, Jiang Yonghong, Wang Biao, Zhao Qinpeng, He Simin, Hao Dingjun
Department of Spine Surgery Department of Radiology, Honghui Hospital, Xi'an Jiaotong University Health Science Center, Xi'an, Shanxi, China.
Medicine (Baltimore). 2018 Feb;97(7):e9984. doi: 10.1097/MD.0000000000009984.
Despite the diverse designs for the lumbar interbody fusion cage, there is no consensus on the optimal design to date. The current study aimed to compare the efficacy and complications associated with the direction-changeable and traditional lumbar cages for treating lumbar spondylolisthesis.We conducted a retrospective study including 109 patients with lumbar spondylolisthesis, who were admitted to our hospital from January 2013 to December 2014. The patients were divided into the direction-changeable (group A) and traditional (group B) lumbar cage group.All patients underwent single-level transforaminal lumbar interbody fusion and were followed up for 12 to 24 months. There were 52 cases in group A and 57 cases in group B. Surgery-related parameters, including operation time, bleeding volume, and hospitalization time, were recorded; there was no significant difference between the 2 groups regarding these parameters. The visual analog scale and Oswestry disability index at the last follow-up showed significant improvement compared with preoperative values in both groups (P < .05). Patients in group A demonstrated more intervertebral space height maintenance postoperatively than patients in group B but the difference was not statistically significant (P > .05). In group A, complications included 3 cases of nonunion (5.77%) and 1 case of cerebrospinal fluid leakage (1.92%). In group B, complications included 9 cases of nonunion (15.79%) and 1 case of postoperative infection (1.75%). There was a significant difference between both groups in terms of the nonunion rate and total complication rate (P < .05).The direction-changeable lumbar cage has merits such as a higher bone fusion rate and fewer postoperative complications compared to the traditional lumbar cage.
尽管腰椎椎间融合器的设计多种多样,但迄今为止,对于最佳设计尚未达成共识。本研究旨在比较可转向腰椎椎间融合器与传统腰椎椎间融合器治疗腰椎滑脱的疗效和并发症。
我们进行了一项回顾性研究,纳入了2013年1月至2014年12月期间我院收治的109例腰椎滑脱患者。患者被分为可转向腰椎椎间融合器组(A组)和传统腰椎椎间融合器组(B组)。所有患者均接受单节段经椎间孔腰椎椎间融合术,并随访12至24个月。A组52例,B组57例。记录手术相关参数,包括手术时间、出血量和住院时间;两组在这些参数方面无显著差异。末次随访时的视觉模拟评分和Oswestry功能障碍指数与术前相比均有显著改善(P<0.05)。A组患者术后椎间高度维持情况优于B组患者,但差异无统计学意义(P>0.05)。A组并发症包括3例骨不连(5.77%)和1例脑脊液漏(1.92%)。B组并发症包括9例骨不连(15.79%)和1例术后感染(1.75%)。两组在骨不连率和总并发症率方面存在显著差异(P<0.05)。
与传统腰椎椎间融合器相比,可转向腰椎椎间融合器具有骨融合率更高、术后并发症更少等优点。