Polymethylmethacrylate(PMMA)augmentation of a cannulated and fenestrated pedicle screw fixation for stabilization of the lumbar degenerative disease accompanied with osteoporosis

摘要

目的:探讨应用聚甲基丙烯酸甲酯(Polymethylmethacrylate，PMMA)骨水泥强化中空侧孔椎弓根螺钉内固定治疗骨质疏松症的腰椎退变性疾病的疗效。
　　方法:2008年6月～2013年1月共收治的骨质疏松症的腰椎退行性病变患者31例，男11例，女20例;年龄为65～86岁，平均73.5岁。其中腰椎管狭窄症14例，腰椎间盘突出症并节段不稳9例，退行性腰椎滑脱症6例，退行性侧凸2例。根据患者症状、体征及影像学资料确定减压、融合节段，采用骨水泥强化中空侧孔椎弓根螺钉系统进行内固定、矫形。
　　结果:所有病例随访36～48个月，平均40个月，未出现断钉、断棒、椎弓根螺钉拔出、松动、融合节段假关节形成以及切口感染等并发症。疼痛VAS评分均低于术前(P＜0.05)，神经症状JOA评分明显改善(P＜0.05)。
　　结论:对于骨质疏松症的腰椎退行性病变患者，应用骨水泥强化型中空侧孔椎弓根螺钉系统内固定，能增强螺钉的稳定性，防止螺钉的松动、拔出，有助于临床疗效的改善和保持。

目录

声明

摘要

ABSTRACT

ABBREVIATION

Catalogue

Chapter 1 Background

1．SPINE

2．Body of vertebra

2．1 Articular surfaces

2．2 Vertebra

3．Intervertebral disc

4．VERTEBRAL ENDPLATE

4．1 Structure

4．2 Biochemical properties

4．3 CERVICAL VERTEBRAE

4．4．THORACIC VERTEBRAE

4．5 LUMBAR VERTEBRAE

4．6 MOVEMENTS OF SPINE

4．7 Thoracic movements

4．8 SPINAL CANAL

4．9 SPINAL STENOSIS

5．Types

5．1 Signs and symptoms

5．2 Neurological disorders

5．3 Causes

6．LUMBAR SPINAL STENOSIS

6．1 History

6．2 Signs and symptoms

6．3 Causes

7．Degenerative spondylolisthesis

7．1 Diagnosis

7．2 Bicycle test of van Gelderen

7．3 Magnetic resonance imaging

7．4 Management

7．5 Medication

7．6 Prognosis

8．Osteoporosis

8．1 Signs and symptoms

8．2 Causes of osteoporosis

8．3 Nonmodifiable

8．4 Potentially modifiable

8．5 Malnutrition

9．DISC DEGENERATION

10．Degenerative Changes of The Vertebral Endplates And Subchondral Bone

11．Biochemical changes

12．Revisions

Chapter 2 Polymethylmethacrylate(PMMA)augmentation of a cannulated and fenestrated pediele screw fixation for stabilization of the lumbar degenerative disease accompanied with osteoporosis

1．Materials and methods

Chapter 3 conclusion and further prospect

ACKNOWLEDGEMENTS

Publication

Reference