皮质轨迹螺钉治疗腰椎融合术后邻椎病的疗效观察

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摘要目的探讨皮质轨迹螺钉(cortical bone trajectory，CBT)治疗腰椎融合术后邻近椎体病(adjacent segment disease，ASD)的可行性。方法回顾性分析十堰市中西医结合医院及西安交通大学附属红会医院2015年1月至2019年9月收治的114例因ASD而行手术治疗的患者，其中女76例，男38例；年龄45～63岁，平均(52.12±5.46)岁。观察并记录患者性别、年龄、手术时间、术中出血量、住院时间、手术节段、术前及术后疼痛视觉模拟评分(visual analogue score，VAS)、术前及术后Oswestry功能障碍指数(Oswestry disability index，ODI)评分，总结CBT应用于ASD的可行性。结果术后所有患者均接受12~26个月的随访，平均随访(16.60±0.48)个月。两组患者均获得满意的疗效，CBT组患者的手术时间(119.43±7.82)min，与传统组(146.72±11.36)min比较明显缩短，术中失血量CBT组(149.00±28.12)mL，也明显小于传统组的(230.00±52.85)mL。术后CBT组患者VAS评分由(4.72±1.32)分改善至(1.75±0.73)分，ODI评分由(40.79±4.90)%改善至(10.30±2.27)%；传统组VAS评分由(5.15±1.15)分改善至(1.89±0.75)分，ODI评分由(40.95±3.91)%改善至(11.15±2.57)%。末次随访时两组患者VAS及ODI评分比较差异均无统计学意义(P＞0.05)。结论 CBT螺钉在处理ASD时能够取得与传统椎弓根螺钉相当的疗效，与传统椎弓根固定方式相比，术中明显减小了创伤，保护了椎体后方组织，减小了出血量，缩短了手术时间，必要时可作为传统椎弓根螺钉的替代技术推广使用。

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	郭瑞 1
	王翰宇 2
	李方 1
	任重 1*
	李琦 3
	郑博隆 4
	贺宝荣 4

关键词 ：腰椎融合术, 邻椎病, 皮质轨迹螺钉

通讯作者: 任重

作者简介: 郭瑞(1992－ )，男，医师，十堰市中西医结合医院骨科，gr_fly@126.com。

引用本文:

郭瑞 1，王翰宇 2，李方 1，任重 1*，李琦 3，郑博隆 4，贺宝荣 4. 皮质轨迹螺钉治疗腰椎融合术后邻椎病的疗效观察[J]. 实用骨科杂志, 2022, 28(1): 58-63.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2022/V28/I1/58

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