保护退变椎间盘的Topping-off技术  

Topping-off technique for the protection of degenerative intervertebral disc

作　　者：赵成[1] 徐建广[1] 连小峰[1] 李浩[1] 邱满乐[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科,上海市200233

出　　处：《中国组织工程研究》2013年第48期8349-8354,共6页Chinese Journal of Tissue Engineering Research

基　　金：上海市科委医学重点项目资助课题(09411953500)~~

摘　　要：背景:Topping-off技术将坚固的融合和棘突间动态装置组合固定治疗,防止或减缓邻近腰椎节段的退变。目的:观察腰后路椎间融合联合Coflex动态固定(Topping-off技术)对退变椎间盘的保护作用。方法:应用Topping-off技术治疗的32例腰椎退变性疾病患者。随访观察Oswestry功能障碍指数、日本骨科协会评估治疗分数(JOA)、Coflex植入节段活动度,MRI图像中Coflex植入节段椎间盘髓核相对信号强度。结果与结论:所有患者获得12个月以上随访。末次随访时,Oswestry功能障碍指数及日本骨科协会评估治疗分数(JOA)评分,均较治疗前明显改善(P<0.001);Coflex植入节段的活动度与治疗前比较,差异无显著性意义(P=0.19);Coflex植入节段相对信号强度较治疗前明显改善(P<0.01)。说明Topping-off技术对椎间盘中短期内有一定的保护作用。BACKGROUND： Topping-off technique can be used for fixation treatment through the combination of fusion and interspinous dynamic device, in order to prevent or slow down the adjacent lumbar segment degeneration. OBJECTIVE： To obverse the protective effect of Topping-off technique（posterior lumbar interbody fusion procedure combined with the fixation of dynamic interspinous device Coflex） for the degenerative intervertebral disc. METHODS： A total of 32 patients with degenerative lumbar diseases who had been treated with Topping-off technique were included in this study. The Oswestry disability index, the Japanese Orthopaedic Association scores, range of motion for Coflex implanted segment and during the relative signal intensity of the Coflex implanted segment in MRI image were recorded and calculated preoperatively and the entire follow-up period. RESULTS AND CONCLUSION： All patients were followed-up for 20.6 months averagely. Up to the last follow-up, the Oswestry disability index and Japanese Orthopaedic Association scores were significantly improved when compared with those before treatment（P 0.001）. There was no significant difference in the range of motion for Coflex implanted segment before and after treatment（P=0.19）. The relative signal intensity of the Coflex implanted segment was significantly improved when compared with that before treatment（P 0.01）. The clinical application of the Topping-off technique showed a protective effect on the intervertebral disc.

关 键 词：骨关节植入物 脊柱植入物 腰椎 椎间融合术 非融合术 动态固定 内固定 相对信号强度 省级基金 

分 类 号：R318[医药卫生—生物医学工程]