棘突间稳定器治疗腰椎退行性疾病的早期疗效观察  

Immediate outcome of interspinous process devices in lumbar intervertebral disc degeneration

作　　者：徐宏光[1] 陈学武[1] 王弘[1] 刘平[1] 丁国正[1] 黄德刚[1] 王凌挺[1] 宣华兵[1] 姜宗园[1] 

机构地区：[1]皖南医学附属弋矶山医院骨二科,安徽芜湖241001

出　　处：《皖南医学院学报》2008年第5期337-339,344,共4页Journal of Wannan Medical College

摘　　要：目的：探讨棘突间稳定器治疗腰椎退行性疾病的早期临床疗效。方法：2008年1-5月间，采用上海锐植生产的棘突间稳定器治疗腰椎间盘突出症伴椎管狭窄患者7例，腰椎节段性不稳定1例；其中男2例，女6例，年龄38-68岁，平均（53．4±11．8）岁；病变部位：L3-4节段1例，L4-5节段7例。采用JOA评分评价手术前、后腰腿痛情况，手术前、后上下终板夹角测定腰椎活动度，中立位腰椎侧位片测量并比较椎间盘高度改变。平均随访（2．8±1．13）个月（0．5-4个月）。结果：术后患者腰腿痛有明显缓解，JOA评分术前20．1±1．46，术后6．9±1．96，两者比较差异有统计学意义（P〈0.05）；终板夹角术前为24．5°±4．4°，末次随访时为24．3°±3．5°，两者比较差异无统计学意义（P〉0．05）；椎间高度术前为（10．2±0．64）mm，末次随访时为（11．5±0．71）mm，两者比较差异有统计学意义（P〈0．05）。结论：正确选择合适的病例，棘突间稳定器治疗腰椎退行疾病是一个有效而可靠的方法。Objective：To evaluate the early results of interspinous process devices for intervertebral disc degeneration with regard to low back pain, the range of movement and intervertebral disc height of lumbar spine. Methods ： Eight patients （2 males, 6 females）, ranging between 38 and 68 years with a mean age of 53.4 years, with intervertebral disc degeneration（7 intervertebral disc hemiation, 1 lumbar segment instability） in the lumbar spine were treated with interspinous process devices during the period of January and May of 2008. The effectiveness of the procedure was evaluated preoperatively by Japanese Orthopedic Association Low back pain score and the last follow-up of the procedure. In addition, restoration of the intervertehral disc height and lumbar range of movement was assscssed on pre-and postoperative radiographs. Results ： The mean JOA scores were 20.1 and 6.9 before operation and the final follow-up of the procedure, respectively （ P 〈0.05）. Slight change of the mean Cobb＇s angle with 24.5 and 24.3 degree , respectively, before and the last follow-up of the prpccdure showed no significance （ P〉0.05）, but the mean intervertebral disc height of 10.2mm and 11.5 mm, respectively, before and the last follow-up of the procedure suggested significant difference（ P 〈 0.05）. All the patients returned to normal activity within the first week. No internal fixation failure and processus spinosus fracture occurred in the treated spinal segment. Conclusion ： lnterspinous process devices is an effectivc and reliable option for lumbar intervertebral disc disease if the case is favorable to this procedure.

关 键 词：棘突间固定 椎间盘突出 腰椎节段性不稳定 

分 类 号：R681.5[医药卫生—骨科学]