棘突间有限植骨融合治疗腰椎间盘突出症

摘要

Objective To investigate the effect and feasibility of the surgery with limited bone grafting surgery between spinous processes for lumbar disc herniation. Methods 11 posterior decompressive laminectomy and allogenic bone grafting surgery between spinous processes were used to treat for patients suffering backleg pain because of lumbar disc herniation. The fusion rate of implanted bone and JOA score were analyzed. Results All patients were followed up for 12 ~ 18 ( 15 ± 1. 22 ) months without wound infection, dura tear, nerve root injury and other complications. The preoperative JOA score was ( 8. 56 ± 1. 45 ), the 3rd postoperative day JOA score was ( 12. 94 ± 1. 55 ), the score was( 13. 15 ±1.21 ) 12 months after operation. Compared with the preoperative JOA score, the difference had statistical significance(P <0. 05 ). The JOA score improvement rates were over 50% . The allograft bones were found absorbed partly or entirely through CT scanning and did not reach the bone fusion. Conclusions It is difficult to achieve bone fusion between the limited allograft bone and spinous processes. Further research need to be done such as the choice of materials,the way to fix etc.%目的 探讨棘突间有限植骨融合治疗腰椎间盘突出症的疗效及可行性.方法 采用后路椎板开窗减压+棘突间同种异体骨有限植入术治疗11例腰椎间盘突出症导致的腰腿痛患者.对植骨融合率、JOA评分进行临床分析.结果 患者均获随访,时间12～18(15±1.22)个月.无切口感染、硬膜囊撕裂、神经根损伤等并发症.术前JOA评分为(8.56±1.45)分,术后3 d为(12.94±1.55)分、12个月为(13.15±1.21)分,与术前比较差异有统计学意义(P＜0.05).JOA评分改善率均＞50%.CT扫描证实棘突间植骨均不同程度被吸收,均未达到骨性融合.结论 单纯在棘突间植入有限的同种异体骨很难达到骨性融合,在材料选择和固定方式等方面须做进一步研究.