Gao Delong, Fang Zhong, Sun Yunlong, Li Feng
Department of Orthopaedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei, 430030, P.R.China.
Department of Orthopaedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei, 430030,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Jul 15;32(7):927-932. doi: 10.7507/1002-1892.201801125.
To explore the fusion effect of allograft Cages on transforaminal lumbar interbody fusion (TLIF).
The clinical data of 30 patients (38 vertebral segments) who underwent TLIF with allograft interbody fusion Cages between January 2015 and January 2017 were retrospectively analysed. There were 25 males and 5 females with an average age of 56.9 years (range, 44-72 years). The lesions included 20 cases of lumbar disc herniation, 7 cases of lumbar spondylolisthesis, and 3 cases of lumbar spinal stenosis. The operation section included 4 cases of L , 13 cases of L , 5 cases of L , S , 6 cases of L -L , S , and 2 cases of L -L . The disease duration was 6-36 months (mean, 12 months). The clinical effectiveness was evaluated by visual analogue scale (VAS) score, Oswestry disability index (ODI), and Japanese Orthopaedic Association (JOA) score at preoperation, 3 months and 6 months after operation, and last follow-up. The fusion rate was evaluated by anteroposterior and lateral X-ray films and CT three-dimensional reconstruction at 3 and 6 months after operation. The intervertebral space height was measured on anteroposterior and lateral X-ray films at preoperation, 3 days, 3 months, and 6 months after operation.
The operation time was 2.1-4.3 hours (mean, 3.1 hours), and the intraoperative blood loss was 150-820 mL (mean, 407.5 mL). The follow-up time was 8-25 months (mean, 16.4 months). One Cage split at 6 months after operation without Cage movement and neurologic symptoms; none of the other patients had Cage prolapse, displacement, and fragmentation. No local or systemic allergy or infection signs was found in all patients. No nerve compression or symptoms was observed during the follow-up. The postoperative VAS score, ODI score, and JOA score improved significantly when compared with preoperative scores ( <0.05); and the scores at 6 months and at last follow-up were significantly improved when compared with those at 3 months after operation ( <0.05); but no significant difference was found between at 6 months and at last follow-up ( 0.05). The fusion rate was 55.3% (21/38), 92.1% (35/38), and 100% (38/38) at 3 months, 6 months, and last follow-up postoperatively. The intervertebral space height was increased significantly at 3 days, 3 months, 6 months, and last follow-up postoperatively when compared with preoperative ones ( <0.05); and the loss of intervertebral space height was significant at last follow-up when compared with postoperative at 3 days ( <0.05).
The allograft interbody fusion Cage contributes to the spine interbody fusion by providing an earlier stability and higher fusion rate.
探讨同种异体骨融合器在经椎间孔腰椎椎体间融合术（TLIF）中的融合效果。
回顾性分析2015年1月至2017年1月期间接受TLIF并使用同种异体骨融合器进行椎体间融合的30例患者（38个椎体节段）的临床资料。其中男性25例，女性5例，平均年龄56.9岁（范围44 - 72岁）。病变包括腰椎间盘突出症20例、腰椎滑脱症7例、腰椎管狭窄症3例。手术节段包括L₄ 4例、L₅ 13例、L₅ - S₁ 5例、L₄ - L₅ 6例、L₅ - S₁ 2例。病程为6 - 36个月（平均12个月）。在术前、术后3个月、6个月及末次随访时，采用视觉模拟评分法（VAS）、Oswestry功能障碍指数（ODI）及日本骨科学会（JOA）评分评估临床疗效。在术后3个月和6个月，通过正侧位X线片及CT三维重建评估融合率。在术前、术后3天、3个月及6个月，通过正侧位X线片测量椎间隙高度。
手术时间为2.1 - 4.3小时（平均3.1小时），术中出血量为150 - 820毫升（平均407.5毫升）。随访时间为8 - 25个月（平均16.4个月）。1例融合器在术后6个月出现裂开，但无融合器移位及神经症状；其他患者均未出现融合器脱垂、移位及碎裂。所有患者均未发现局部或全身过敏或感染征象。随访期间未观察到神经受压或症状。与术前评分相比，术后VAS评分、ODI评分及JOA评分均显著改善（P < 0.05）；与术后3个月评分相比，术后6个月及末次随访时评分显著改善（P < 0.05）；但术后6个月与末次随访时评分差异无统计学意义（P > 0.05）。术后3个月、6个月及末次随访时的融合率分别为55.3%（21/38）、92.1%（35/38）和100%（38/38）。与术前相比，术后3天、3个月、6个月及末次随访时椎间隙高度均显著增加（P < 0.05）；与术后3天相比，末次随访时椎间隙高度丢失显著（P < 0.05）。
同种异体骨融合器通过提供早期稳定性和更高的融合率，有助于脊柱椎体间融合。
