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[目的]对比可灌注椎弓根骨水泥螺钉与可膨胀椎弓根螺钉应用于严重骨质疏松老年患者腰椎退变疾病手术的临床效果.[方法]选择本院2012～2015老年腰椎退变疾病合并严重骨质疏松患者30例;完善术前X线片、CT及MRI检查后,15例行经皮可灌注骨水泥螺钉固定+Mis-TILF减压手术技术,另15例行可膨胀螺钉固定+Mis-TILF减压手术技术.分别记录术前、术后VAS评分、JOA评分以及椎弓根钉松动率并进行统计分析.[结果]所有患者均顺利手术,术中均未出现神经损伤、骨水泥渗漏.所有患者随访1年以上.VAS评分随术后时间延长而逐渐减小、JOA评分随术后时间延长而逐渐增加,不同时间点间的差异均有统计学意义(P＜0.05).随访中均未见螺钉断钉、断棒现象.可灌注椎弓根骨水泥螺钉组所有患者椎弓根螺钉未见松动现象,可膨胀椎弓根螺钉组有2例患者椎弓根钉出现不同程度松动,占可膨胀螺钉组13.3％,两组椎弓根钉松动率差异有统计学意义.[结论]微创下中空可灌注骨水泥螺钉应用于老年严重骨质疏松患者,在术后恢复过程中效果更可靠,固定更牢固,不易松动,可为老年微创手术患者提供稳定有效的脊柱内固定.“,”[Objective] To compare clinical efficacy of percutaneous cemented screws versus expandable screws in minimally-invasive surgical transforaminal lumbar interbody fusion (MIS-TLIF) for lumbar degenerative disease accompanied with serious osteoporosis.[Methods] We treated 30 patients with lumbar degenerative disease and serious osteoporosis by MIS-TLIF from 2012 to 2015.Of them,15 patients had affected spinal segment fixed using cemented pedicle screws,while the remaining 15 patients underwent internal fixation with expandable pedicle screws.The VAS,JOA scores and screw loosening were compared between the two groups.[Results] All the patients had operation smoothly without nerve injury and bone cement leakage during operation happened in any patient of the two group.All of them were followed up more than 1 year.Compared with those before operation,the VAS significantly decreased,whereas the JOA scores considerably increased as time elapsed after operation in both group (P＜0.05).At the latest follow up,no screw breakage and rod fracture were noted in anyone of both groups.No screw loosening occurred in any patient of the cemented screw group,by contrast,2 patients presented screw loosening in the expandable screw group accounted for 13.3％,associated with a statistical difference between the two group (P＜0.05).[Conclusion] The cemented screw in MIS-TLIF for lumbar degenerative disease accompanied with serious osteoporosis,with advantages of more stable fixation and less screw loosening,does achieve more reliable clinical outcome over the expandable screw.