可膨胀性椎间融介器在腰椎退行性疾病治疗中的临床应用[摘耍]冃的:探讨可膨胀性椎间融合器治疗腰椎追行性疾病的效果。方法:2009年4月〜2010年5月我院对50例患者采用可膨胀性椎间融合器治疗腰椎退行性疾病,其中采用后路椎间盘镜下操作治疗的有41例,采用后外侧经皮穿治疗的有9例。冋顾性分析其临床资料,对其治疗效果、植骨融合率、椎间隙高度及并发症等进行分析。结果:术后随访吋间8〜38个月,平均16个月,按照Odom标准对治疗效果进行评价。结果显示,36例为优,占72%;9例为良,占18%;4例为可,占8%;1例为差,占2%。患者的症状得到明显改善,其优良率达90%。CT影像显示椎间盘突出并椎管严重狭窄,椎间融合器没有移位现象,与骨已融合,椎间高度没冇明显下降。术后对患者进行随访仅冇3例出现并发症,占6%。结论:可膨胀性椎间融合器治疗腰椎退行性疾病,具有创伤小、安全性高、融合率高、恢复良好等优点,具有很好的应用前景,值得进行临床推广应用。[关键词]可膨胀性椎间融合器;腰椎退行性疾病;临床应用[中图分类号]R681.5[文献标识码]B[文章编号]1673-7210(2011)12(b)-180-02ApplicationofexpandablespinalspacerinlumbardegenerativediseaseWANGHongbol,YANJun2,LIUShixuel,ZHAOYouchunl,PENGJunl,LIChunhual1・DepartmentofOrthopedic,ShenzhenShajingHospitalAffiliatedtoGuangzhouMedicalCollege,GuangdongProvince,Shenzhen518104,China;2・DepartmentofRehabilitation,ShenzhenShajingHospitalAffiliatedtoGuangzhouMedicalCollege,GuangdongProvinee,Shenzhen518104,China[Abstract]Objective:Toexploretheclinicaltherapeuticeffectofexpandablespinalspacerinlumbardegenerativedisease・Methods:50patientsinlumbardegcnerativediseaseweretreatedwithexpandablespinalspacerfromApril2009toMay2010inourhospital,ofwhichtherewere41caseswhoobtainedthemicroscopicposteriordiscoperationtreatment,9caseswhoobtainedthelateralpercutaneousweartreatment.Theclinicaldataoftreatmenteffect,fusionrate,bonegraftheightandcomplicationswereanalyzedretrospectively・Results:Inthefollow-uptimefor8-38months,theeffectswereevaluatedaccordingtothestandardofOdom・Theresultsshowedthat,36caseswereexcellent,accountingfor72%;9caseswerewell,accountedfor18%;4caseswerecommon,accountedfor8%;1casewasinferior,accountedfor2%.Thesymptomsofpatientsimprovedobviously,itsgoodratecouldamountto90%.CTimageshowedthattherewasnodischerniationandvertebracanalstenosis,andalsonoshiftphenomenonbetweenvertebraandexpandablespinalspacer,thebonohadmerged,bonegraftheighthadnotobviouslydecreased.Patientswerefollowedupwiththeresultsofonly3casesofcomplicationswiththeincidenceratewas6%.Conelusion:Expandablespinalspacerappliedtotreatthelumbardegenerativediseasehassmalltrauma,highsafety,fusionratehigh,goodrestoreandotheradvantages,whichhasagoodapplicationprospectandisworthyofclinicalapplication.[Keywords]Expandablespinalspacer;Lumbardegenerativediseases;Clinicalapplication腰椎退行性疾病是医院骨科常见的多发病。近儿年來,具发病率呈逐年上升的趋势,有些患者经非手术治疗效果不理想盂经手术治疗,然而虽然采用传统的椎间融合器栢入术治疗腰椎退行性疾病已取得一定的治疗效果,但其缺点很明显,手术创伤人、并发症多而且术后恢复缓慢[1]。为了提高治疗腰椎退行性疾病的治疗效果,我院于2009年4月〜2010年5月对50例患者采用可膨胀性椎间融合器治疗腰椎退行性疾病,取得较好的治疗效果。现报道如下:1资料与方法1.1一般资料本组共有50例腰椎退行性疾病患者,其中,男27例,女23例;年龄27〜64岁,平均47岁。病例入选标准:出现严重的卜•釀痛症状,且经正规保守治疗效果不明显或无效者;出现I〜II度的腰椎滑脱、腰椎管狭窄及侧弯症状;腰椎节段不稳;腰椎间盘突出合并椎间隙狭窄;出现复发性椎间盘突...