经椎弓根螺钉固定与椎间融合治疗腰骶椎滑脱的比较研究

A. Yosri, Gasser Al-Shyal, A. Shehab
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摘要

腰骶椎滑脱是一种常见的病理,其特征是腰椎在另一腰椎上发生单节段或多节段滑脱,可能与椎管狭窄和神经孔受损有关,并可能出现腰痛、神经根性疼痛或神经源性跛行性疼痛。本研究旨在比较两种手术融合技术治疗该病理的短期临床效果。患者和方法共纳入40例腰骶椎滑脱患者。根据手术入路和固定技术的不同,将患者随机分为两组。A组行后路腰椎减压、经椎弓根螺钉固定、后外侧横间骨融合术。B组行后路减压、经椎弓根螺钉、后外侧横间骨融合术并置入椎间笼进行椎间融合术。结果两组在手术时间、出血量、术后融合率方面差异均有统计学意义,但在术中、术后并发症发生率、临床结局、患者满意度方面差异无统计学意义。结论腰椎椎体间保持器联合后外侧横间融合具有更好的融合率,但在患者满意度和术后临床改善方面效果相同,且手术时间较短。
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Comparative study of transpediculer screw fixation and intertransverse fusion with and without interbody cage insertion in management of lumbosacral spondylolisthesis
Background Lumbosacral spondylolisthesis is a common pathology characterized by single or multilevel slippage of lumbar vertebra over the other and may be associated with spinal canal stenosis and neural foramina compromise and may present with lower back pain, radicular pain, or neurogenic claudication pain. The current study aimed to compare the short-term clinical outcomes of two surgical fusion techniques in the management of this pathology Patients and methods A total of 40 patients with lumbosacral spondylolisthesis were included in this study. Patients were randomly divided into two groups according to the surgical approach and fixation technique used in the management. Group A was operated by posterior lumbar decompression, transpedicular screw fixation, and posterolateral intertransverse bony fusion. Group B was operated by posterior decompression, transpedicular screw, and posterolateral intertransverse bony fusion associated with interbody fusion by insertion of interbody cages. Results Statistical significance was reached in the duration of surgery, blood loss, and postoperative fusion rates, but there was no significant difference between the two groups regarding intraoperative or postoperative complication rates, clinical outcome, and patient satisfaction. Conclusion The application of the lumbar interbody cage with posterolateral intertransverse fusion proved to have better fusion rates, but still intertransverse bony fusion alone gives the same results regarding patient satisfaction and postoperative clinical improvement with shorter operative time.
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