局部骨移植和富血小板血浆腰椎融合术的疗效：治疗老年人退行性腰椎管狭窄症的临床研究

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-09-17 DOI:10.1007/s00264-024-06294-2

Chaojun Wang, Fengzhou Xu, Lisha Jia, Yongqiang Liu, Shuangwei Zhang

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引用次数: 0

摘要

目的本研究旨在全面评估利用自体骨移植和富血小板血浆（PRP）进行腰椎融合术治疗老年退行性腰椎管狭窄症（DLSS）的临床效果。对照组 20 人接受局部植骨进行椎间融合术，观察组 20 人接受局部植骨和 PRP 联合进行腰椎融合术。采用核磁共振成像技术对脊柱结构进行全面评估。通过核磁共振成像评估脊柱融合术的疗效。临床治疗效果采用日本骨科协会（JOA）和Oswestry残疾指数（ODI）评分系统进行评估。结果在最后的随访中，观察组的椎管内径和椎间盘间隙高度比对照组显著增加（P < 0.05）。此外，观察组的椎间融合连续性评分高于对照组（P <0.05）。观察组的 JOA 评分明显高于对照组（P <0.05），而 ODI 评分明显低于对照组（P <0.05）。值得注意的是，在术后三个月和最后随访时，观察组的背痛 VAS 评分均低于对照组（P < 0.05）。观察组的满意率和总体满意率均明显高于对照组（P < 0.05），而观察组的不满意率明显低于对照组（P < 0.05）。结论在老年 DLSS 的治疗中，局部植骨和 PRP 在腰椎融合术中的应用效果显著。

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Lumbar fusion efficacy with local bone grafting and platelet-rich plasma: a clinical investigation in treating degenerative lumbar spinal stenosis in the elderly

Purpose

The focus of this study was to comprehensively assess the clinical outcomes of lumbar fusion utilizing autogenous bone grafting and platelet-rich plasma (PRP) for the management of degenerative lumbar spinal stenosis (DLSS) in elderly individuals.

Method

A cohort of 40 senior individuals diagnosed with DLSS, who underwent treatment at our hospital between January 2020 and March 2022. The control group consisted of 20 participants who underwent local bone grafting for intervertebral fusion, while the observation group comprised 20 individuals who received a combination of local bone grafting and PRP for lumbar fusion. MRI imaging was employed for a comprehensive assessment of spinal structure. The efficacy of spinal fusion was evaluated through MRI imaging. Clinical treatment outcomes were assessed using the Japanese Orthopaedic Association (JOA) and Oswestry Disability Index (ODI) scoring systems. Postoperative low back pain was quantified using a Visual Analog Scale (VAS).

Result

During the final follow-up, the observation group demonstrated a significant increase in the inner diameter of the spinal canal and the height of the disc space compared to the control group (P < 0.05).Moreover, the observation group displayed a larger spinal canal than the control group (P < 0.05).A reduced lesion score in the bone grafting region was observed in the observation group compared to the control group during the final follow-up (P < 0.05). Furthermore, the observation group displayed a higher intervertebral fusion continuity score than the control group (P < 0.05).The JOA score in the observation group was significantly higher than in the control group (P < 0.05), while the ODI score was significantly lower (P < 0.05). Of note, the back pain VAS score in the observation group was lower than in the control group at both the three months post-surgery mark and the final follow-up (P < 0.05).The satisfaction rate and overall satisfaction rate in the observation group were significantly higher than those in the control group (P < 0.05), while the dissatisfaction rate in the observation group was evidently lower than in the control group (P < 0.05).