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侧后方斜向植入单枚BAK的腰椎椎体间融合术:临床初步报告

Posterior lumbar interbody fusion with single BAK insertion: a primary clinical report

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【作者】 赵杰侯铁胜张春才海涌邹德威OrdwayNatHansenYuan

【Author】 ZHAO Jie 1, HOU Tie Sheng 1, ZHANG Chun Cai 1, HAI Yong 2, ZOU De Wei 2, Ordway Nat 3, Hansen Yuan 3 (1. Depa rtment of Orthopedic, Changhai Hospital, Second Militery Medical University, Shanghai 200433, China; 2. Hospital No.514, PLA; 3. New

【机构】 第二军医大学长海医院骨科!上海200433解放军第514医院美国纽约州立大学

【摘要】 目的:设计侧后方斜向植入单枚多孔螺纹状椎间融合器(BAK)行后路腰椎体间融合术的术式,观察该方法治疗20例下腰痛患者的初步临床疗效。方法:对20 例严重下腰痛(18 例伴下肢神经症状)的患者,采用本研究设计的术式共融合28个椎间隙(L4~5 间隙16 个,L5 ~S1 间隙12个),其中4例行2 个椎节融合术的患者附加行Steffee 钢板内固定术。结果:本组平均随访12.5个月,除1 例外,皆达到临床融合,均无融合器移位,患者主观满意率90% 。结论:侧后方斜向植入单枚多孔螺纹状椎间融合器行腰椎椎体间融合术,既能尽可能多地保留脊柱后部结构,又能充分完成后路减压,还能保证可靠的融合,不失为一种比较理想的后路腰椎椎体间融合术式。

【Abstract】 Objective: To establish posterior lumbar interbody fusion (PLIF) by posterolateral insertion of single threaded cage(BAK) through posterior approach with unilateral facetectomy and evaluate its safety, fusion success rate and clinical outcome. Methods: For a 18 month period, 20 patients with severe low lumbar pain underwent PLIF with single posterolateral BAK insertion, 4 of them with additional instrumentation of Steffee pedicle screw fixation system. All patients were followed up from 6 to 18 months (average 12.5 months). Results: Nineteen achieved clinical fusion. Eighteen of the 20 patients had a 90% or better improvement over the preoperative symptoms. There were 2 patients had an early, substantial foot drop which disappeared within 3 months. Conclusion: PLIF by posterolateral insertion of single BAK by a posterior approach with unilateral facetectomy enables sufficient decompression and solid interbody fusion to be achieved while maintaining a majority of the posterior elements.

【基金】 上海市科委学科带头人!基金资助项目(97XD14015)
  • 【文献出处】 第二军医大学学报 ,ACADEMIC JOURNAL OF SECOND MILITARY MEDICAL UNIVERSITY , 编辑部邮箱 ,2000年01期
  • 【分类号】R681.5
  • 【被引频次】19
  • 【下载频次】56
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