| 胥 云,闫 康,张小平,郭卫东,鲍小明,廖 博.皮质骨轨迹螺钉与椎弓根螺钉行经椎间孔入路椎间融合术的疗效比较[J].,2019,19(24):4660-4664 |
| 皮质骨轨迹螺钉与椎弓根螺钉行经椎间孔入路椎间融合术的疗效比较 |
| Clinical and Radiological Comparison between Cortical Bone Trajectory Screw and Pedicle Screw in Transforaminal Lumbar Interbody Fusion |
| 投稿时间：2019-05-17 修订日期：2019-06-12 |
| DOI：10.13241/j.cnki.pmb.2019.24.013 |
| 中文关键词: 皮质骨轨迹螺钉 椎弓根螺钉 经椎间孔椎间融合术 腰椎退行性疾病 |
| 英文关键词: Cortical bone trajectory Pedicle screw Transforaminal lumbar interbody fusion Degenerative lumbar diseases |
| 基金项目:国家自然科学基金项目(81372045)；唐都医院院创新项目(2015LCYJ020) |
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| 中文摘要: |
| 摘要 目的：探讨皮质骨轨迹螺钉（cortical bone trajectory，CBT）与椎弓根螺钉（pedicle screw，PS）行经椎间孔入路椎间融合术（transforaminal lumbar interbody fusion ，TLIF）治疗腰椎退行性疾病的临床疗效。方法：选取2016年5月至2018年5月采用TLIF治疗的腰椎退行性疾病患者资料50例作为研究对象，其中行CBT螺钉固定组25例，行PS螺钉内固定组25例。分别记录患者一般资料、围手术期参数及并发症发生情况。腰痛VAS评分、腿痛VAS评分及ODI功能指数评分评估临床效果。Bridwell分级标准评价两组融合情况。结果：平均随访时间16.72±3.6个月。两组患者在性别、年龄、疾病诊断、手术节段方面组间差异无统计学意义（P>0.05）。皮质骨轨迹螺钉组平均手术时间及术中出血量为171.88±25.75 min、225.20±51.57 mL，椎弓根螺钉组为221.24±33.53 min、297.60±66.40 mL，两组比较差异有统计学意义（P<0.05）。两组患者术后1月及末次随访腰痛VAS评分、腿痛VAS评分及ODI功能指数评分均较术前有明显改善，两组间差异无统计学意义。末次随访两组患者均取得骨性融合。结论：对于腰椎退行性疾病患者，采用CBT螺钉和PS螺钉内固定方式行TLIF均能到达良好的临床疗效及融合率，采用皮质骨轨迹螺钉行TLIF患者手术时间短，术中出血量更少。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the clinical and radiological outcomes of cortical bone trajectory (CBT) screw and pedicle screw (PS) for transforaminal lumbar interbody fusion (TLIF) in degenerative lumbar diseases. Methods: 50 patients from May 2016 to May 2018 were enrolled into this retrospective study. CBT screw was applied in 25 patients (CBT-TLIF Group) and PS was applied in 25 patients (PS-TLIF Group). General condition, perioperative parameters and complications were recorded and analyzed. VAS of back pain, VAS for leg pain and ODI were used to evaluate the clinical efficacy. Bridwell classification was used to evaluate the fusion. Results: Average follow-up duration was 16.72±3.6 months. There is no difference between two groups in gender, age, diagnosis, and surgical segments. Operation duration and blood lost in the CBT-TLIF group was 171.88±25.75 min, 225.20±51.57 mL, and 221.24±33.53 min, 297.60±66.40 mL in PS-TLIF group. Significant difference was found in the above parameters between two group (P<0.05). Both groups had significant improvements in the ODI (Oswestry disability index) and VAS (Visual Analogue Scale) scores at 1month after operation and the last follow up, but no significant difference was found between the two groups. Comparable fusion rates of both groups were also observed by radiography. Conclusion: CBT-TLIF and PS-TLIF had comparable functional outcomes and fusion rate, while CBT-TLIF had superiority in and operation duration and blood control. |
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