融合与非融合术固定治疗腰椎单节段退变性疾病的临床观察  

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

作　　者：曾昭池[1] 郭中凯[1] 朱志勇[1] 汪海军[1] 朱凡[1] 

机构地区：[1]解放军第169医院骨科

出　　处：《中国矫形外科杂志》2013年第1期34-36,共3页Orthopedic Journal of China

摘　　要：[目的]探寻腰椎单节段退变性疾病的有效治疗措施。[方法]126例患者分别使用融合术与非融合术进行治疗,每组63例,术前、术后及随访2年采用VAS及ODI评分进行临床疗效观察,并通过X线片测量ROM。[结果]两组患者的VAS、ODI结果显示,无论是术后疼痛减轻程度,还是腰椎功能均较术前明显改善,单两组相比较,无统计学意义(P>0.05)。非融合组L3、4、L4、5及L5S13个节段的活动度在术后3个月时均较术前增加明显,差异有统计学意义(P<0.05);融合组L3、4活动度在术后3个月时均较术前增加明显,差异有统计学意义(P<0.05),随访2年增加明显(P<0.05);L4、5固定节段活动丧失,L5S1活动度在术后3个月时均较术前增加明显,差异有统计学意义(P<0.05);两组间比较,随访2年L3、4的活动度,融合组较非融合组增加显著,差异具有显著统计学意义(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均可取得满意疗效,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 of posterior single segment fusion and non -fusion in lumbar spinal disease. [ Methods] A total of 126 cases of degenerative lumbar spinal disorder were treated with Coflex （ group non - fusion） and PLIF （group fusion） , and were followed up for over 2 years. The clinical effect was evaluated by VAS and ODI. ROM of lumbar segments was measured by X - ray film. [ Results ] Postoperative VAS and ODI showed significant improvements than that of pre - operation in terms of pain decrease and lumbar function in both 2 groups. There was no significant difference between 2 groups （ P 〉 0.05 ） . The motion range of L3,4, L4,5, L5 St improved significantly in non - fusion group （ P 〈 0.05 ） . The motion range of L3,4 improved significantly in fusion group （ P 〈 0. 05 ）, more improvement was found at 2 year follow - up （ P 〈 0. 05 ） . The motion range was lost in L4,5, the motion range of L5 S1 improved significantly at 3 month follow - up （ P 〈 0. 05） . At 2 years postoperative follow up, the improvement in fusion group was better than that of non - fusion group, with significant difference （ P 〈 0. 05 ） . [ Conclusion] Both fusion and non - fusion fixation have satisfactory effects in treatment of degenerative lumbar spinal disorder. Non -fusion fixation has less influence on ROM of lumbar segment 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]