腰椎棘突间稳定装置的临床应用及随访结果分析  

Clinical application and follow- up results analysis of the interspinous dynamic fixation

作　　者：王义生[1] 梁昌详[1] 柯雨洪[1] 肖丹[1] 詹世强[1] 刘斌[1] 昌耘冰[1] 郑秋坚[1] 

机构地区：[1]广东省医学科学院广东省人民医院骨科,广州510080

出　　处：《中国矫形外科杂志》2014年第7期584-588,共5页Orthopedic Journal of China

摘　　要：[目的]探讨腰椎棘突问稳定装置Coflex和Wallis置入适应证的扩宽和禁忌证相对缩窄的可行性，对比两种装置各自的优缺点及改良、研制新型装置的必要性。[方法]回顾2008年7月～2012年1月间收治的行棘突间稳定装置置人的患者，置入Coflex247例、Wallis130例共387套装置，将最后诊断再行一次分类；对比术前及末次随访时的JOA（Japanese Orthopaedic Association）、VAS（Visual Analogue Scale）、ODI（Oswestry Disability Index）评分。[结果]最后诊断占大比例的有腰椎间盘突出症、腰椎管狭窄症，小部分为棘突碰撞综合征、盘源性腰痛、小关：节综合征和退变性椎节不稳定，部分病例将其作为Topping—off使用。平均随访时间31．8个月（J3～52个月）。JOA、VAS、ODI均有显著性差异。[结论]Cotlex和Wallis的即时稳定，早、中期疗效满意，可考虑适度放宽病种的适应证，腰椎间盘突出症不必列为禁忌证。但具体病变的轻重、类型需加以严格区分，避免使用于重度病例。[Objective] To discuss the feasibility of extending the indications and narrowing the contraindications of the Coflex and Wallis. To compare the advantages and disadvantages of both devices. To discuss the necessity of developing new devices. [ Methods] The patients receiving tbe Wallis implantation or and the Cotlex implantation were retrospectively investigated from July 2008 to March 2012. There were 247 cases of Coflex and 130 cases of Wallis. The JOA score, VAS score and ODI score were preoperatively compared and postoperatively compared at follow up. [ Results] Most of the diagnosis were lumbar imerver- tebral disc herniation and lumbar spinal stenosis, some of the cases were spines collision syndrome, discogenic low back pain, facet joint syndrome, the rest cases were used as Topping - oil. All patients were followed - up with an average of 31.8 months （13 -35 months） . There were statistical significances between preoperative and postoperative score of the JOA, VSA and ODI. [ Conclusion ] With the immediate stability and satisfying early to midterm outcome, the indications of Coflex and Wallis could be extended. The lumbar intervertebral disc herniation can be an indication, but they should not be used in the severe cases.

关 键 词：棘突间稳定装置 COFLEX WALLIS 腰椎退变性疾病 

分 类 号：R687.3[医药卫生—骨科学]