后外侧及后外侧与椎间融合联合入路中使用局部骨的腰椎融合率
Lumbar Spine Fusion Rates With Local Bone in Posterolateral and Combined Posterolateral and Interbody Approaches.
作者信息
Park Daniel K, Roberts Richard, Arnold Paul, Kim David H, Sasso Rick, Baker Kevin C, Fischgrund Jeffrey S
机构信息
Department of Orthopaedic Surgery, Beaumont Health, Royal Oak, MI (Dr. Park, Dr. Roberts, Dr. Baker, and Dr. Fischgrund); the Department of Neurosurgery, University of Kansas Hospital, Kansas City, KS (Dr. Arnold); the Department of Orthopaedic Surgery, New England Baptist Hospital, Boston, MA (Dr. Kim); and Indiana Spine Center, Caramel, IN (Dr. Sasso).
出版信息
J Am Acad Orthop Surg Glob Res Rev. 2019 Nov 4;3(11):e018. doi: 10.5435/JAAOSGlobal-D-18-00018. eCollection 2019 Nov.
UNLABELLED
Posterolateral lumbar fusion (PLF) used to treat degenerative lumbar conditions still faces pseudarthrosis. Bone graft choice is a key factor; a traditional choice has been autologous iliac crest bone graft (ICBG), but complication rates are quoted up to 39%. Local bone from laminectomy eliminates ICBG harvesting complications.
METHODS
Two hundred forty-one patients underwent either PLF or PLF with interbody at a single lumbar level with a prospective, multicenter, randomized controlled trial only using local bone graft. Fusion was assessed with radiographs and CT.
RESULTS
PLF fused bilaterally in 18% and unilaterally in 28.8% at 6 months and 35.7% and 50.3% at 12 months, respectively. At 6-month PLF + interbody, 1.1% fused bilaterally and 11.7% unilaterally; at 12 months, 5.4% fused all three areas, and 50.8% fused at least one area.
DISCUSSION
Local bone fused substantially less than the "benchmark" ICBG.
未标注
用于治疗退行性腰椎疾病的后外侧腰椎融合术（PLF）仍面临假关节形成问题。骨移植的选择是一个关键因素；传统的选择是自体髂嵴骨移植（ICBG），但其并发症发生率高达39%。椎板切除术获取的局部骨可避免ICBG采集的并发症。
方法
241例患者在单一腰椎节段接受了PLF或PLF联合椎间融合术，采用前瞻性、多中心、随机对照试验，仅使用局部骨移植。通过X线片和CT评估融合情况。
结果
PLF在6个月时双侧融合率为18%，单侧融合率为28.8%；在12个月时，双侧融合率为35.7%，单侧融合率为50.3%。在6个月时，PLF + 椎间融合术双侧融合率为1.1%，单侧融合率为11.7%；在12个月时，三个区域均融合的比例为5.4%，至少一个区域融合的比例为50.8%。
讨论
局部骨融合明显少于“标准”的ICBG。
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