后路椎间盘镜下单个可膨胀融合器固定融合 术治疗腰椎退行性疾病的远期疗效分析

Long-term efficacy of intervertebral fusion using single B-Twin expandable spinal spacer through microendoscopic approach for lumbar degenerative disease

摘要:

目的 探讨后路椎间盘镜下使用单个可膨胀融合器（B-Twin ESS）固定融合术治疗腰椎退行性疾病的远期临床疗效。方法 回顾性分析2007年2月~2010年1月由同一术者完成的21例共22个间隙使用单个B-Twin ESS固定融合术的病例，随访38～64个月，平均50个月，分析术前与术后随访时的JOA评分和椎间隙高度变化，用Suk标准评估椎间隙融合情况。结果 21例患者术前JOA评分为（11.6±2.9）分，末次随访为（26.6±1.5）分，末次随访时的JOA改善率为64.7%～94.4%，平均为86.4%，疗效均达到显效；术前病变椎间隙高度为（9.5±1.5）mm，术后1周为（11.5±1.3）mm，术后6个月为（10.0±1.4）mm，末次随访为（9.4±1.7）mm，术后6个月与末次随访比较差异有显著性（P >0.05）。9例（40.9%）达到坚固融合，13例（56.3%）达到可能融合，0例未融合患者。结论 经后路椎间盘镜下使用单个B-Twin ESS固定一个椎节治疗腰椎退行性疾病远期症状改善率好，但融合率有待提高。

Abstract:

【Objective】 To investigate long-term efficacy of interbody fusion using single B-Twin ESS through microendoscopic approach for lumbar degenerative disease. 【Methods】 A retrospective analysis was made on data of 21 cases or 22 disc levels underwent fusion using a single B-Twin ESS by a same surgeon from Feb. 2007 to Jan. 2010. The follow-up time ranged from 38 to 64 months and averaged 50 months. JOA were scored preoperatively and postoperatively and the disc height were measured at every follow-up. Healing state of the bone graft in the disc space was evaluated by Suk's criteria. 【Results】 JOA score were (11.6±2.9) preoperatively and (26.6±1.5) at final follow-up, respectively, JOA improvement rate was 64.7%~94.4%, the average was 86.4%, improvement was markedly effective postoperatively in all 21 cases at the final follow-up; The average disc height was (9.5±1.5) mm preoperatively, (11.5±1.3) mm at 1 week postoperatively, (10.0±1.4) mm at 6 months postoperatively and (9.4±1.7) mm at final follow-up, respectively, and the difference between the disc height at 6 months postoperatively and at final follow-up was significant (P ＞0.05). Solid union occurred in 9 cases (40.9%) and probable union in 13 cases (56.3%), None nonunion case was found by Suk's criteria. 【Conclusion】 The long-term efficacy was satisfied interms of pain relieve for lumbar degenerative disease with fusion using single B-Twin ESS through microendoscopic approach, but the solid fusion rate needs to be improved.