人工腰椎间盘置换术与单纯髓核摘除术治疗退行性腰椎间盘疾病的近期疗效比较  

Comparison of short-term curative effects between artificial disc replacement and simple discectomy for treatment of degenerative disc disease

作　　者：吴亮[1] 孙晓亮[1] 张雷[1] 吴国峰[1] 周剑[1] Yve Cartonne Pascal Moussellard 

机构地区：[1]苏州大学常州第一人民医院骨一科,常州213003 [2]Pitie-Salpetriere Hospital,the 6th University of Paris

出　　处：《中国矫形外科杂志》2011年第21期1769-1772,共4页Orthopedic Journal of China

基　　金：常州市卫生局青年人才项目(编号:QN200805)

摘　　要：[目的]对人工腰椎间盘置换术和单纯髓核摘除术治疗退行性腰椎间盘疾病的近期临床疗效进行比较。[方法]2007年5月～2010年5月行人工腰椎间盘置换术治疗退行性腰椎间盘疾病12例,其中男性7例,女性5例;平均年龄40.2岁(28～54岁)。同期行单纯髓核摘除术治疗退行性腰椎间盘疾病20例,其中男性11例,女性9例;平均年龄38.1岁(24～51岁)。对两组病例手术前后的视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、腰椎活动度(ROM),以及椎间隙高度进行分析比较。[结果]随访时间平均20.1个月(6～30个月)。术后两组病例的VAS评分、ODI评分均较术前有显著改善(P<0.05)。末次随访时两组病例的VAS评分和ODI评分无统计学差异(P>0.05)。术后6个月两组ROM比较无显著差异(P>0.05),但末次随访时椎间盘置换组的ROM显著优于髓核摘除组(P<0.05)。术后椎间盘置换组椎间隙高度较术前显著增加(P<0.05),髓核摘除组椎间隙高度与术前相比无显著差异(P>0.05)。[结论]对于退行性腰椎间盘疾病,人工腰椎间盘置换术和单纯髓核摘除术均可达到良好的近期临床疗效。但在改善腰椎活动度和恢复椎间隙高度方面,人工腰椎间盘置换术更具优势。[Objective]To evaluate the short-term curative effects of artificial disc replacement（ADR） and simple discectomy for treatment of degenerative disc disease. [Methods]Twelve ADR and 20 simple discectomy for the treatment of degenerative disc disease were preformed from May 2007 to May 2010.Seven males and 5 females with an average age of 40.2 years underwent ADR.Eleven males and 9 females with an average age of 38.1 years underwent simple discectomy.The visual analogue scale（VAS）,Oswestry Disability Index（ODI）,the range of motion（ROM） of the involved lumbar segment,and intervertebral height of the two groups before and after operation were compared. [Results]The follow-up time averaged 20.1 months（6~30 months）.The post-operative VAS and ODI of the two groups significantly improved（P0.05）.But the VAS and ODI of the two groups showed no significant difference at the last follow-up（P0.05）.At 6 months after operation,the ROM of the two groups showed no significant difference（P0.05）.But the ROM of the patients with ADR was more improved than patients with simple discectomy at the last follow-up（P0.05）.The post-operative intervertebral height of the patients with ADR was significantly improved（P0.05）.The intervertebral height of the patients with simple discectomy before and after operation showed no significant difference（P0.05）. [Conclusion]Both ADR and simple discectomy can acquire satisfactory short-term curative effects for treatment of degenerative disc disease.Compared to simple discectomy,ADR showed more superiorities in improving ROM of the involved lumbar segment and restoring the intervertebral height.

关 键 词：腰椎 椎间盘 髓核 假体和置入物 

分 类 号：R687.3[医药卫生—骨科学]