半限制非融合钛钉内固定系统Cosmic治疗腰椎退行性疾病：中期随访结果  

Semi-restricted non-fusion system(Cosmic) in the treatment of lumbar degenerative disease: mid-term follow-up outcomes

作　　者：李尔楠[1] 匡正达[2] 

机构地区：[1]首都医科大学附属北京世纪坛医院矫形外科,北京市100038 [2]武警总医院骨三科,北京市100039

出　　处：《中国组织工程研究》2015年第39期6327-6332,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:相比于坚强内固定,Cosmic半限制非融合系统可于术中减少对腰椎生理结构的破坏,保留手术节段部分活动度,维持节段稳定性,有助于预防毗邻节段退变。目的:观察Cosmic半限制非融合系统治疗腰椎退行性疾病的中期随访结果。方法:纳入腰椎退行性疾病患者21例,其中男10例,女11例,年龄19-63岁,均采用后路开窗减压,清除髓核,在手术节段置入Cosmic半限制非融合系统,评估治疗前后的目测类比评分、Oswestry功能障碍指数,以及手术节段、毗邻上节段的椎间隙高度与活动范围。结果与结论:所有患者治疗后接受随访15-48个月,未发生内固定松动、断裂与脱落,末次随访的目测类比评分、Oswestry功能障碍指数均低于治疗前(P<0.01)。末次随访时,手术节段及毗邻上节段的椎间隙高度与治疗前比较差异均无显著性意义,手术节段的活动度低于治疗前(P<0.01),毗邻上节段的活动度与治疗前比较差异无显著性意义。表明Cosmic半限制非融合系统可于术中减少对腰椎生理结构的破坏,保留手术节段部分活动度,维持节段稳定性,有助于预防毗邻节段退变,中期疗效较好。BACKGROUND： Compared with rigid internal fixation, semi-restricted non-fusion system（Cosmic） can reduce the destruction of lumbar physiological structure during operation, partly retain the range of motion, maintain the stability of surgical segment, and help to prevent the adjacent segment degeneration. OBJECTIVE： To observe the mid-term follow-up outcome of semi-restricted non-fusion system（Cosmic） in the treatment of lumbar degenerative disease. METHODS： 21 patients with lumbar degenerative disease, including 10 male patients and 11 female patients, at the age of 19-63 years old, received posterior decompression by fenestration, nucleotomy, and Cosmic system internal fixation. Visual analogue scale score and Oswestry disability index were used for clinical evaluation. Intervertebral height and range of motion of surgical segment and the proximal adjacent segment were collected before and after operation. RESULTS AND CONCLUSION： All the patients were followed up for 15-48 months. No internal fixator loosening or rupture was found during the follow-up. The visual analogue scale score and Oswestry disability index at the last follow-up were lower than those before operation（P〈0.01）. During the last follow-up, there were no significant differences in the intervertebral height of surgical segment and the proximal adjacent segment, and the range of motion of surgical segment was lower than that before operation（P〈0.01）. No significant difference was found in range of motion of the proximal adjacent segment. These results suggest that semi-restricted dynamic non-fusion system（Cosmic） can reduce the destruction of lumbar physiological structure during operation, partly retain the range of motion, maintain the stability of surgical segment, and help to prevent the adjacent segment degeneration with well mid-term follow-up outcomes.

关 键 词：内固定器 腰椎 脊柱融合术 骨科植入物 脊柱植入物 坚强内固定技术 半限制 非融合 腰椎退行性疾病 中期临床效果 

分 类 号：R318[医药卫生—生物医学工程]