后路椎间融合术与后前路联合手术治疗老年骨质疏松性椎体骨折合并腰椎管狭窄症的临床疗效比较

doi:10.3969/j.issn.1671-7171.2020.09.011

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Abstract 【Objective】 To investigate the efficacy and safety of posterior lumbar interbody fusion (PLIF) and posterior-anterior combined surgery (PACS) in the treatment of osteoporotic vertebral compression fracture (OVCF) with lumbar spinal stenosis (LSS).【Methods】 The clinical data of 37 elderly patients with OVCF complicated with LSS who were treated in our hospital from January 2013 to January 2018 were retrospectively analyzed. Among them, 14 cases were treated with PLIF (PLIF group), and 23 cases were treated with PACS (PACS group). The operation time, blood loss, postoperative hospital stay, postoperative complications and other clinical data were compared between the two groups. The American Spinal Injury Association Injury Scale (AIS) rating, lumbar lordosis angle (LLA) and bone fusion results of the two groups were observed before and after operation.【Results】 The AIS grading of the PLIF group and the PACS group was significantly improved compared with that before operation (P<0.05), but there was no significant difference in AIS grading between the two groups before and after operation (P>0.05). The ADLs scores of the PLIF group and the PACS group were significantly improved compared with those before operation (P<0.05). There was no significant difference in ADLs between the two groups before and after operation (P>0.05). The operation time, intraoperative blood loss and postoperative hospital stay in the PLIF group were significantly less than those in the PACS group (P<0.05).There was no significant difference between the PLIF group and the PACS group in LLA, LLA correction degree, correction loss and spinal fusion rate before, after and at the last follow-up (P>0.05). There was no significant difference in the incidence of pulmonary infection, dural tear, knife edge infection, pedicle screw loosening, adjacent vertebral fracture and reoperation between the PLIF group and the PACS group (P>0.05).【Conclusion】 For the elderly patients of OVCF combined with LSS, PLIF can fully decompress the spinal canal through a single posterior approach, and achieve posterior fixation through pedicle screw and hook screw system. Its surgical trauma is lower than that of PACS, and the clinical effect is satisfactory, which is worthy of clinical application.

Key words： Fractures Bone/SU Osteoporosis/CO Spinal Stenosis/SU Spinal Fusion

Received: 28 July 2020

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KE Chang-wu. Comparison of the Clinical Efficacy of PLIF with PACS in the treatment of OVCF with LSS[J]. JOURNAL OF CLINICAL RESEARCH, 2020, 37(9): 1312-1315.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2020.09.011 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2020/V37/I9/1312

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[1]	. [J]. JOURNAL OF CLINICAL RESEARCH, 2020, 37(9): 1412-1415.