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骨水泥注射型空心椎弓根螺钉短节段固定治疗伴有骨质疏松的腰椎滑脱症的临床疗效。

Clinical efficacy of Bone Cement-injectable Cannulated Pedicle Screw Short Segment Fixation for Lumbar Spondylolisthesis with Osteoporosise.

机构信息

Department of Spine surgery, Army Medical Center of PLA, Chongqing, 400042, People's Republic of China.

Department of Orthopedics, Southwest Hospital of Army Medical University, PLA, Chongqing, 400038, People's Republic of China.

出版信息

Sci Rep. 2020 Mar 3;10(1):3929. doi: 10.1038/s41598-020-60980-w.

Abstract

Many clinical studies have shown a satisfactory clinical efficacy using bone cement-augmented pedicle screw in osteoporotic spine, however, few studies have involved the application of this type of screw in lumbar spondylolisthesis. This study aims to investigate the mid-term clinical outcome of bone cement-injectable cannulated pedicle screw (CICPS) in lumbar spondylolisthesis with osteoporosis. From 2011 to 2015, twenty-three patients with transforminal lumbar interbody fusion (TLIF) using CICPS for lumbar spondylolisthesis were enrolled in the study. Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) were used to evaluate faunctional recovery and physical pain; and operation time, blood loss and hospitalization time were recorded, respectively. Radiograph and computed tomography of lumbar spine was performed to assess loss of the intervertebral disc space height, fixation loosening, and the rate of bony fusion. The average follow-up time of 23 patients was 22.5 ± 10.2 months (range, 6-36 months). According to VAS and ODI scores, postoperative pain sensation and activity function were significantly improved (p < 0.05). The height of the intervertebral disc space was reduced by 0.4 ± 1.1 mm, and the bone graft fusion rate was 100%. No cases of internal fixation loosening or screw pullout was observed. CICPS using cement augmentation may suggest as a feasible surgical technique in osteoporotic patients with lumbar spondylolisthesis.

摘要

许多临床研究表明,在骨质疏松性脊柱中使用骨水泥增强椎弓根螺钉可获得满意的临床疗效,但是,很少有研究涉及这种螺钉在腰椎滑脱症中的应用。本研究旨在探讨骨水泥可注射空心椎弓根螺钉(CICPS)在骨质疏松性腰椎滑脱症中的中期临床疗效。2011 年至 2015 年,我们对 23 例采用 CICPS 行经椎间孔腰椎体间融合术(TLIF)的腰椎滑脱症患者进行了研究。采用 Oswestry 功能障碍指数(ODI)和视觉模拟量表(VAS)评估功能恢复和身体疼痛情况;记录手术时间、出血量和住院时间。分别进行腰椎 X 线和 CT 检查,以评估椎间盘空间高度丢失、固定松动和骨融合率。23 例患者的平均随访时间为 22.5±10.2 个月(6-36 个月)。根据 VAS 和 ODI 评分,术后疼痛感觉和活动功能明显改善(p<0.05)。椎间盘空间高度降低了 0.4±1.1mm,植骨融合率为 100%。未发现内固定松动或螺钉拔出的病例。在骨质疏松性腰椎滑脱症患者中,CICPS 联合骨水泥固定可能是一种可行的手术技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78d2/7054412/496d850d2219/41598_2020_60980_Fig1_HTML.jpg

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