椎弓根皮质骨通道与常规通道螺钉治疗骨质疏松性腰椎疾病Cortical bone trajectory versus traditional pedicle screw techniques for osteoporotic lumbar degenerative disease
付荣华;耿晓鹏;付国勇;邴爱玲;
摘要(Abstract):
[目的]比较椎弓根皮质骨通道螺钉固定术(CBT)与常规椎弓根螺钉内固定术(PS)在治疗腰椎退行性变合并骨质疏松症患者的临床疗效。[方法] 2016年5月~2018年5月65例患者纳入本研究,其中采用CBT内固定融合术30例(CBT组),采用PS内固定融合术35例(PS组)。记录围手术期资料,采用视觉模拟评分(VAS)、日本骨科协会量表(JOA)和影像检查评估临床疗效。[结果]两组患者均顺利完成手术,PS组有1例硬脊膜破裂。两组均无神经、脊髓损伤等并发症。CBT组的手术时间、术中出血量及术后引流量均显著少于PS组,差异有统计学意义(P<0.05);术中透视次数明显多于PS组,差异有统计学意义(P<0.05);术中切口长度明显小于PS组,差异有统计学意义(P<0.05)。术后随访9个月以上,随时间推移,两组患者VAS评分均显著减少,而JOA评分显著增加,不同时间点间差异有统计学意义(P<0.05);相同时间点,两组间VAS评分和JOA评分的差异均无统计学意义(P>0.05)。至末次随访,CBT组仅1例螺钉松动,而PS组3例螺钉松动,但差异无统计学意义(P>0.05);CBT组2例椎间未融合,PS组3例椎间未融合,差异无统计学意义(P>0.05)。[结论]椎弓根皮质骨通道螺钉内固定术与常规通道椎弓根螺钉内固定术在治疗腰椎退行性变合并骨质疏松症患者方面都取得了良好的疗效,椎弓根皮质骨通道螺钉固定术在术中出血量、手术时间方面优于常规通道椎弓根螺钉内固定术。
关键词(KeyWords): 皮质骨螺钉;椎弓根螺钉;腰椎退行性疾病;骨质疏松症
基金项目(Foundation): 山东省自然科学基金资助项目(编号:ZR2017LH020)
作者(Author): 付荣华;耿晓鹏;付国勇;邴爱玲;
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