目的 探究生物活性玻璃联合聚醚醚酮椎间融合器在经椎间孔入路椎间融合术（TLIF）中的应用效果。方法 回顾性纳入2017年1月—2023年12月因腰椎退变性疾病行TLIF治疗的174例患者,根据植骨材料不同分为自体骨组（99例）和生物活性玻璃组（75例）。收集患者基本信息、手术信息、随访资料等,对融合节段的平衡参数及融合进程进行影像学测量。比较两组患者手术时间、手术出血量、术后下床时间、住院时间、Oswestry功能障碍指数（ODI）;比较分析两组患者手术前后椎间隙高度和前凸角,以及植骨融合结果。结果 两组患者手术时间、手术出血量、术后下床时间、住院时间比较,差异均无统计学意义（P>0.05）。两组患者手术后5 d的ODI均较术前降低, 差异有统计学意义（P<0.05）,但术前、术后两组间差异均无统计学意义（P>0.05）。术后6个月,两组融合节段椎间隙前缘和后缘高度均较术前明显改善,差异有统计学意义（P<0.05）,两组之间差异无统计学意义（P>0.05）;融合节段前凸角均较术前扩大,差异有统计学意义（P<0.05）,两组之间差异无统计学意义（P>0.05）。两组术后随访均未发现植骨不愈和假关节。结论 腰椎聚醚醚酮椎间融合器联合生物活性玻璃植骨效果良好,能够显著恢复融合节段的椎间隙高度和前凸角。
Objective To evaluate the efficacy of a bioactive glass （BG） and polyetheretherketone （PEEK） interbody fusion cage in transforaminal lumbar interbody fusion （TLIF） procedures. Method A retrospective analysis was performed on 174 patients who underwent TLIF surgery for lumbar degenerative diseases from January 2017 to December 2023. Patients were categorized into an autogenous bone graft （ABG） group （99 cases） and a bioactive glass group （75 cases） based on the bone graft material used. Patient demographics, surgical details, follow-up details, fusion segment balance parameters, and fusion progression images were collected. Surgical duration, intraoperative blood loss, postoperative mobilization time, hospital stay, and Oswestry Disability Index （ODI） were compared between the two groups. Pre- and post-operative intervertebral space height and lordosis angle, as well as bone graft fusion outcomes were also compared between the two groups. Results No statistically significant differences （P>0.05） were observed between the two groups in terms of surgical time, blood loss, postoperative mobilization time, or hospital stay. Pre- and post-operative ODI scores did not differ significantly between the groups （P>0.05）; however, both groups demonstrated a statistically significant reduction in ODI scores 5 d postoperatively compared to preoperative levels （P<0.05）. Both groups exhibited significant improvements in anterior and posterior disc height compared to preoperative measurements （P<0.05）, with no statistically significant difference between the two groups （P>0.05）. The lordosis angle of the fused segment improved significantly postoperatively in both groups （P<0.05）, with no statistically significant difference between the groups （P>0.05）. Postoperative follow-up revealed no cases of bone graft failure or pseudarthrosis in either group. Conclusion The combination of a PEEK interbody fusion cage with bioactive glass bone graft in lumbar spine surgery demonstrates good efficacy, significantly restoring intervertebral space height and lordosis angle in the fused segment.
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