Kuslich S D, Ulstrom C L, Griffith S L, Ahern J W, Dowdle J D
Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, USA.
Spine (Phila Pa 1976). 1998 Jun 1;23(11):1267-78; discussion 1279. doi: 10.1097/00007632-199806010-00019.
A prospective, multicenter trial of the Bagby and Kuslich method of lumbar interbody stabilization for chronic discogenic low back pain, with follow-up evaluation at 3 months, 6 months, and yearly thereafter, with independent radiographic analysis.
To report the history of development, the surgical techniques, and results of the Bagby and Kuslich method when used to manage discogenic pain of the lumbar spine in humans.
Disabling chronic low back pain frequently is resistant to conservative management. The "Bagby Basket" effectively has fused the equine and baboon spine. The results of biomechanical and animal studies performed over the last 20 years have suggested that a similar but improved design--the Bagby and Kuslich device--would be useful in stabilizing the human spine.
From 1992 to 1995, 947 patients with chronic discogenic low back pain were treated by Bagby and Kuslich interbody fusion in a strict, multicenter, prospective clinical trial by using either the open anterior or open posterior approach. The study involved 42 surgeons at 19 medical centers. The authors of the current report analyzed the fusion rates, pain relief, functional status, and complications occurring in patients who underwent long-term follow-up observation.
The Bagby and Kuslich method is safe and effective when compared with methods described in previous reports of posterior and anterior lumbar interbody arthrodesis performed by using bone graft alone. Fusion occurred in 91% of patients at 24 months after surgery, and pain was eliminated or reduced in 84%. Function was improved in 91%. There were no device-related deaths, cases of major paralyses, device failures, or deep infections.
Carefully selected middle-aged patients with chronic low back pain secondary to degenerative disc disease can be treated effectively and safely by skilled surgeons using the Bagby and Kuslich device for one- and two-level interbody fusion.
一项关于采用Bagby和Kuslich腰椎椎间融合术治疗慢性椎间盘源性下腰痛的前瞻性多中心试验，术后3个月、6个月及此后每年进行随访评估，并进行独立的影像学分析。
报告Bagby和Kuslich方法用于治疗人类腰椎间盘源性疼痛的发展历程、手术技术及结果。
致残性慢性下腰痛通常对保守治疗无效。“Bagby椎间融合器”已成功实现马和狒狒脊柱的融合。过去20年进行的生物力学和动物研究结果表明，一种类似但改进的设计——Bagby和Kuslich装置——将有助于稳定人类脊柱。
1992年至1995年，在一项严格的多中心前瞻性临床试验中，采用开放前路或开放后路手术，对947例慢性椎间盘源性下腰痛患者实施Bagby和Kuslich椎间融合术。该研究涉及19个医学中心的42名外科医生。本报告的作者分析了接受长期随访观察患者的融合率、疼痛缓解情况、功能状态及并发症。
与既往单纯使用骨移植进行腰椎前后路椎间融合术的报告中所描述的方法相比，Bagby和Kuslich方法安全有效。术后24个月时，91%的患者实现融合，84%的患者疼痛消除或减轻。91%的患者功能得到改善。未发生与装置相关的死亡、严重瘫痪、装置故障或深部感染病例。
对于精心挑选的因退行性椎间盘疾病继发慢性下腰痛的中年患者，可以由技术熟练的外科医生使用Bagby和Kuslich装置进行单节段或双节段椎间融合，从而安全有效地进行治疗。
