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腰椎后路器械融合术:一项前瞻性研究,评估接受棘突间固定装置治疗退行性脊柱疾病患者的融合效果。

Instrumented Posterior Arthrodesis of the Lumbar Spine: Prospective Study Evaluating Fusion Outcomes in Patients Receiving an Interspinous Fixation Device for the Treatment of Degenerative Spine Diseases.

作者信息

Skoblar Matthew, Hedman Thomas, Rogers Adam J, Jasper Gabriel P, Beall Douglas P

机构信息

The Jasper Spine Institute, Brick Township, NJ, USA.

University of Kentucky, Lexington, KY, USA.

出版信息

J Pain Res. 2023 Aug 24;16:2909-2918. doi: 10.2147/JPR.S417319. eCollection 2023.

Abstract

PURPOSE

Prospective evaluation of radiographic fusion outcomes in patients receiving instrumented posterior arthrodesis of the lumbar spine using a minimally invasive interspinous fixation device.

PATIENTS AND METHODS

All patients (n = 110) from a single US physician's practice who received instrumented posterior arthrodesis of the lumbar spine with a minimally invasive interspinous fixation device in the calendar year 2020 were invited to return for a follow-up CT scan to radiographically assess fusion. Forty-three patients, representing 69 total treated levels, consented to participate and received a lumbar CT scan at a mean of 459 days post-surgery (177 to 652). The interspinous/interlaminar fusion was assessed by 3 independent radiologists using a novel grading scale. Spinous process fractures were also assessed.

RESULTS

92.8% of the assessed levels were considered fused. There were no intraoperative spinous process fractures. There were 4 spinous process fractures (5.8%) identified on CT imaging, all of which were asymptomatic and healed without subsequent intervention. There were no instances of device mechanical failure or device-related reoperation.

CONCLUSION

Instrumented posterior arthrodesis of the lumbar spine using a minimally invasive interspinous fixation device provides clinically meaningful fusion rates with no reoperations and a low risk of spinous process fracture or other device-related complications.

摘要

目的

对使用微创棘突间固定装置进行腰椎后路器械融合术的患者的影像学融合结果进行前瞻性评估。

患者与方法

邀请2020日历年中来自美国单一医生诊所的所有接受微创棘突间固定装置腰椎后路器械融合术的患者(n = 110)回来进行随访CT扫描,以影像学方式评估融合情况。43名患者,共代表69个治疗节段,同意参与并在术后平均459天(177至652天)接受了腰椎CT扫描。由3名独立放射科医生使用一种新的分级量表评估棘突间/椎板间融合情况。还对棘突骨折进行了评估。

结果

92.8%的评估节段被认为已融合。术中无棘突骨折。CT成像发现4例棘突骨折(5.8%),均无症状且无需后续干预即愈合。无器械机械故障或与器械相关的再次手术情况。

结论

使用微创棘突间固定装置进行腰椎后路器械融合术可提供具有临床意义的融合率,无需再次手术,且棘突骨折或其他与器械相关并发症的风险较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf04/10463371/59d558f6a485/JPR-16-2909-g0001.jpg

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