椎弓根钉弹性棒固定治疗两节腰椎椎间盘突出症的临床疗效观察  

The observation of clinical efficacy of flexible transpedicle fixation system in treatment of two segment lumbar degenerative diseases

作　　者：卫秀洋[1] 陈勇忠[1] 王金星[1] 黄哲[1] 龚衍丁 

机构地区：[1]南京军区福州总医院476临床部骨科,福建福州350002

出　　处：《东南国防医药》2015年第4期349-352,共4页Military Medical Journal of Southeast China

基　　金：南京军区医学科技创新课题(11MB028)

摘　　要：目的：对比弹性固定术和坚强固定术治疗两节腰椎间盘突出症疗效及对上节段椎体间隙退变的影响。方法2012年1月－2013年1月，收集64例两节腰椎椎间盘突出症，按手术方法不同分两组，观察组用弹性棒非融合固定术34例，对照组用椎间椎弓根钉棒系统坚强固定术30例。采用疼痛视觉模拟评分法（ visual analog scale，VAS）评价临床疗效，并通过X线片测量腰椎各间隙高度，评估生物力学改变。结果所有病例均随访，随访15～36个月，平均26．4月，两组术后2年末次随访时VAS评分较术前都明显降低，差异有统计学意义（ P＜0.05）。两组术后1周时VAS 评分差异无统计学意义（ P＞0.05）。术后2年末次随访时，观察组的上节段椎体间隙高度与术前比较减少不显著，差异不具有统计学意义（ P＞0.05）；对照组的上节段椎体间隙高度与术前比较减少明显，差异具有统计学意义（ P＜0.05）。结论坚强固定和弹性固定治疗腰椎间盘突出症都取得较好临床疗效，弹性固定术对降低相邻节段退变的发生具有优势。Objective To compare the treatment effects posterior two segment lumbar spinal disease , between flexible trans-pedicle fixation system and traditional rigid fixation system, to evaluate clinical efficacy and their influence on adjacent segments. Methods From Jan 2012 to Jan 2013, a total of 64 cases of lumbar disc herniation（ LDH） were treated.The consents form the pa-tients were obtained.34 patients undergoing flexible transpedicle fixation system were classified as study group and 30 patients undergo-ing conventional fusion was used as controls.The clinical effect was evaluated by visual analogue scale （visual analog scale, VAS）. The intervertebral height was measured by X-ray film.The biomechanicalchanges in vivo were evaluated.Results All patients were followed up for 15-36 months （mean, 26.4 months）.The VAS score was significantly decreased compared with preoperative last fol-low-up （P〈0.05）.No significant difference of VAS score was found in two groups in early stage （P〉0.05）.In flexible transpedicle fixation system group, there was no statistical difference in the intervertebral height of the adjacent segment between the last follow up postoperation and preoperative （P〉0.05）.In traditional rigid fixation system group,the difference was significant （P〈0.05）.Flexi-ble fixed disc height to maintain more strong than fixation group.Conclusion Both exible transpedicle and traditional rigid fixation system have satisfying effects in treatment of degenerative lumbar spinal disorder.Flexible fixed segment degenerationin reducing the incidence of adjacent advantage.

关 键 词：腰椎间盘突出症 弹性固定 坚强固定 椎弓根钉 邻近节段退变 

分 类 号：R681.53[医药卫生—骨科学]