腰椎后路单节段融合与非融合固定的对比分析  

Posterior single segment fusion or non-fusion in treatment of lumbar spinal disease:a comparative study

作　　者：陈肇辉[1] 付强[1] 王聪[1] 侯铁胜[1] 

机构地区：[1]第二军医大学附属长海医院骨科,上海市200433

出　　处：《中国矫形外科杂志》2010年第8期629-632,共4页Orthopedic Journal of China

摘　　要：[目的]比较融合与非融合术治疗腰椎单节段退变性疾病的临床疗效及其对相邻节段的影响。[方法]分别使用Coflex固定(非融合组)及PLIF术(融合组)治疗腰椎退行性病变(L4/5)32例,随访2年余,采用疼痛视觉模拟评分法(VAS)评分及Oswestry功能障碍指数(ODI)评价临床疗效,并通过X线片测量腰椎各间隙活动度(ROM)。[结果]非融合组最后随访时VAS从7.8±1.2降低至2.1±0.6;ODI从30.8±3.2降低至4.6±1.2;腰椎各节段活动度较术前有改善(P<0.01)。融合组最后随访时VAS从7.2±1.1降低至2.0±0.6;ODI从29.9±3.0降低至4.5±0.9;L3/4节段活动度最后随访时较术后3个月时明显增加(P<0.01)。两组疗效没有统计学差异(P>0.05)。[结论]融合与非融合固定治疗单间隙腰椎退变性疾病皆可取得满意疗效,非融合术对腰椎节段活动度影响小,可能会降低相邻节段退变的发生。[ Objective] To compare the treatment effects between posterior single segment fusion or non-fusion in lumbar spinal disease, and to evaluate their influence on adjacent segments. [ Method] Thirty-two cases of degenerative lumbar spinal disorders were treated with Coflex （group non-fusion） and PLIF （group fusion） , and followed up for over 2 years. The clinical effect was evaluated by visual analogue scale （VAS） and Oswestry disability index （ ODI ）. Range of motion （ ROM ） of lumbar segments was measured by X-ray film. [ Result] In group non-fusion, VAS decreased from 7.8 ± 1.2 pre-operatively to 2.1 ± 0.6 at final follow-up, ODI from 30.8 ± 3.2 to 4.6 ± 1.2, ROM improved significantly. In group fusion, VAS decreased from 7.2 ± 1.1 to 2.0 ± 0. 6, ODI from 29.9 ± 3.0 to 4.5 ± 0.9, and ROM of L3,4 improved significantly. No significant difference of clinical effect was found between 2 groups. [ Conclusion] Both fusion and non-fusion fixation have satisfying effects in treatment of degenerative lumbar spinal disorder. Non-fusion fixation has less influence on ROM of lumbar segments and could reduce adjacent segment degeneration.

关 键 词：腰椎 融合 非融合 邻近节段退变 

分 类 号：R687.3[医药卫生—骨科学]