Cosmic和Dynesys动态非融合系统治疗腰椎退变性疾病的疗效比较  

Comparative analysis of Cosmic dynamic non-fusion system and Dynamic stabilization system in the surgical treatment of lumbar degenerative diseases

作　　者：徐杏平[1] 刘伟[1] 陈昌伟[1] 幸永明[1] 王杰[1] 

机构地区：[1]解放军第一一三医院骨一科,浙江宁波315040

出　　处：《临床军医杂志》2015年第9期941-944,共4页Clinical Journal of Medical Officers

摘　　要：目的：比较Cosmic动态非融合系统和Dynesys动态稳定系统治疗腰椎退变性疾病的临床疗效。方法将2011年10月至2014年1月我院收治的45例腰椎退变性疾病患者,随机分为Cosmic动态非融合系统手术组（23例）和Dynesys经椎弓根动态稳定系统手术组（22例）,观察两组患者手术时间、术中出血、术后临床疗效以及手术节段脊柱活动度（ROM）等的差异。结果 Dynesys组手术时间[（1.6±0.5） h]较Cosmic组[（1.4±0.3）h]偏长,两组间术中出血量比较差异无统计学意义（P＞0.05）。两组患者随访时间0.8～2.5年（平均1.6年）。术后6个月随访时,Cosmic 组患者临床疗效优19例（83%）、良3例（13%）,可1例（4%）；Dynesys组患者术后临床疗效优18例（82%）、良4例（18%）。两组患者在术前、术后6个月、术后1年随访时的VAS评分及ODI评分方面进行组间比较,差异无统计学意义（P＞0.05）。 Cosmic组术后1年随访时手术节段ROM为（7.62±2.31）°,略大于Dynesys组的（6.44±2.72）°,两组间比较差异有统计学意义（P＜0.05）。结论Cosmic系统在手术时间和术后脊柱节段ROM方面优于Dynesys系统,但Cosmic和Dynesys系统在治疗腰椎退变性疾病均取得良好疗效,与脊柱融合术比较,都可以明显减少术中出血和降低术中神经损伤的风险,对脊柱生理结构破坏少,术后可早期下地活动,减少术后康复时间,有较好的临床应用前景。Objective To analyze and compare the therapeutic effect of Cosmic dynamic non-fusion system or Dynamic stabilization system （ Dynesys） in the surgical treatment of lumbar degenerative diseases by Randomized clinical controlled study. Methods Total-ly 45 isolated patients from October 2011 to January 2014 with lumbar degenerative diseases were enrolled in our study and randomly divided into two groups to receive either Cosmic system or Dynesys system,and observe the differences in operative time,blood loss, clinical efficacy and Segmental spinal range of motion （ ROM） between the two groups. Results The operation time in Cosmic system group （1. 4 ± 0. 3） hours was less than the Dynesys system group （1. 6 ± 0. 5） hours （P〈0. 05）,but the blood loss between the two groups had no significant difference. After a mean of 1. 6 years （range from 0. 8 to 2. 5 years） follow-up,the outcome of surgical treat-ment showed excellent in 19 cases （83%）,good in 3 cases （13%） and fair in 1 cases （4%） in Cosmic system group;while which were excellent in 18 cases （82%）,good in 4 cases （18%） in Dynesys system group. There was no statistically significant difference in VAS and ODI scores between the two group before surgery,and at 6 months,1 year follow-up postoperatively. After one year follow-up,the surgical segmental spinal ROM was （7. 62 ±2. 31） degrees in the Cosmic system group,and it was （6. 44 ± 2. 72） degrees in the Dynesys system group （P〈0. 05）. Conclusion The operation time and Segmental spinal range of motion of the Cosmic system were better than the Dynesys system,but both Cosmic and Dynesys system could get a good outcome in the treatment of lumbar degen-erative diseases. Compared with the spinal fusion systems,the non-fusion systems though pedicle screws could significantly reduce the blood loss intraoperation and the risks of nerve damage,which could also reduce the destruction of the spine,postoperative recovery time and have a good clinical application pr

关 键 词：动态非融合固定 腰椎退变性疾病 Cosmic动态非融合系统 Dynesys动态稳定系统 外科治疗 

分 类 号：R681.53[医药卫生—骨科学]