CBT螺钉技术治疗骨质疏松腰椎退变性疾病的疗效分析

目的 应用皮质骨通道(Cortical bone trajectory,CBT)螺钉技术进行椎体间融合是一种较新的技术,本研究对CBT螺钉技术在治疗骨质疏松腰椎退变性疾病中的初期临床疗效进行评价。方法 回顾性分析我院2015—2018年应用CBT螺钉技术进行椎间融合术治疗20例骨质疏松腰椎退变性疾病患者的临床资料。记录并分析患者年龄、手术时间、术中失血量、神经损伤情况、住院时间,术前、术后随访Oswestry功能障碍指数(Oswestry disabiliby index,ODI)、视觉模拟评分(Visual Analogue Scale/Score,VAS)、椎间融合率。结果 平均手术时间183.2 min,平均术中失血量375.7 mL,平均住院时间4.56天。随访时间16~24个月,平均19.2个月,100%的病人获得融合。术后ODI和VAS评分数值较术前减小,并有统计学意义。结论 在治疗骨质疏松腰椎退变性疾病时,CBT螺钉有更强的抗拔出力,能够获得可靠的固定,临床疗效满意,创伤更小,是一种安全、可靠、微创的置钉方法。

Effect analysis of cortical bone trajectory screw for osteoporotic lumbar degenerative disease

Objective The aim of this study was to evaluate the outcomes of cortical bone trajectory (CBT) screws in the posterior lumbar fusion surgery of lumbar disease with osteoporosis by a retrospective study, a relatively new technique. Methods This is a retrospective cohort study. All patients that underwent circumferential lumbar interbody fusion with CBT screws in our hospital from 2015 to 2018 were reviewed. Patient age, clinical outcome with visual analogue scale (VAS) and Oswestry Disability Index (ODI), operative blood loss, hospital stay and the fusion rate were evaluated. Results All patients obtained follow-up 16 to 24 months postoperative, with an average of 19.2 months. Oswestry Disability Indexes and Visual Analogue Scores improved significantly at 3 months postoperative. Mean procedural time was 183.2 min. The mean operative blood loss was 375.7 mL. The mean hospital stay was 4.56 days. The fusion was obtained in 100% of cases. Mean ODI and VAS index postoperative improved with statistical significance. Conclusion The use of cortical bone trajectory (CBT) screws for interbody fusion is safe and effective to patients with osteoporosis. While the technique has less trauma, shorter operative time, hospital stays and good fusion rate.