Department of Orthopaedics, Shijiazhuang People's Hospital, No.365 Jianhua South Street, Shijiazhuang, 050011, Hebei, China.
Int Orthop. 2024 Nov;48(11):2963-2970. doi: 10.1007/s00264-024-06294-2. Epub 2024 Sep 17.
The focus of this study was to comprehensively assess the clinical outcomes of lumbar fusion utilizing autogenous bone grafting and platelet-rich plasma (PRP) for the management of degenerative lumbar spinal stenosis (DLSS) in elderly individuals.
A cohort of 40 senior individuals diagnosed with DLSS, who underwent treatment at our hospital between January 2020 and March 2022. The control group consisted of 20 participants who underwent local bone grafting for intervertebral fusion, while the observation group comprised 20 individuals who received a combination of local bone grafting and PRP for lumbar fusion. MRI imaging was employed for a comprehensive assessment of spinal structure. The efficacy of spinal fusion was evaluated through MRI imaging. Clinical treatment outcomes were assessed using the Japanese Orthopaedic Association (JOA) and Oswestry Disability Index (ODI) scoring systems. Postoperative low back pain was quantified using a Visual Analog Scale (VAS).
During the final follow-up, the observation group demonstrated a significant increase in the inner diameter of the spinal canal and the height of the disc space compared to the control group (P < 0.05).Moreover, the observation group displayed a larger spinal canal than the control group (P < 0.05).A reduced lesion score in the bone grafting region was observed in the observation group compared to the control group during the final follow-up (P < 0.05). Furthermore, the observation group displayed a higher intervertebral fusion continuity score than the control group (P < 0.05).The JOA score in the observation group was significantly higher than in the control group (P < 0.05), while the ODI score was significantly lower (P < 0.05). Of note, the back pain VAS score in the observation group was lower than in the control group at both the three months post-surgery mark and the final follow-up (P < 0.05).The satisfaction rate and overall satisfaction rate in the observation group were significantly higher than those in the control group (P < 0.05), while the dissatisfaction rate in the observation group was evidently lower than in the control group (P < 0.05).
In the management of DLSS in elderly individuals, the utilization of local bone grafting and PRP in lumbar spinal fusion yields notable outcomes.
本研究旨在全面评估自体骨移植和富血小板血浆（PRP）联合应用于老年退行性腰椎管狭窄症（DLSS）患者腰椎融合术的临床效果。
选取 2020 年 1 月至 2022 年 3 月在我院接受治疗的 40 名老年 DLSS 患者作为研究对象。对照组 20 例患者采用局部植骨椎间融合术，观察组 20 例患者采用局部植骨联合 PRP 进行腰椎融合术。所有患者均进行 MRI 影像学评估，比较两组患者的脊柱结构。采用 MRI 影像学评估融合效果，采用日本骨科协会（JOA）和 Oswestry 功能障碍指数（ODI）评分系统评估临床治疗效果，采用视觉模拟评分（VAS）评估术后腰痛程度。
末次随访时，观察组的椎管内径和椎间盘高度均显著大于对照组（P<0.05），且观察组的椎管内径也显著大于对照组（P<0.05）。末次随访时，观察组患者的植骨区域病变评分显著低于对照组（P<0.05），且观察组患者的椎间融合连续性评分显著高于对照组（P<0.05）。观察组的 JOA 评分显著高于对照组（P<0.05），ODI 评分显著低于对照组（P<0.05）。此外，观察组患者术后 3 个月和末次随访时的腰痛 VAS 评分均显著低于对照组（P<0.05）。观察组的满意度和总满意度均显著高于对照组（P<0.05），观察组的不满意率显著低于对照组（P<0.05）。
在老年退行性腰椎管狭窄症患者的治疗中，局部植骨联合 PRP 进行腰椎融合术可取得显著的临床效果。
