应用单侧Isobar TLL动态非融合内固定系统治疗腰椎间盘突出症的临床效果  

Curative effect of lumbar disc herniation treated with unilateral Isobar TLL dynamic fixation system

作　　者：马宁[1] 高延征[1] 高坤[1] 张敬乙[1] 余正红[1] 盛伟超[1] 邢帅[1] 吕东波 Ma Ning;Gao Yanzheng;Gao Kun;Zhang Jingyi;Yu Zhenghong;Sheng Weichao;Xing Shuai;Lv Dongbo(Department of Spine Surgery, Affiliated People's Hospital of Zhengzhou University, Zhengzhou 450000, China)

机构地区：[1]郑州大学附属人民医院脊柱外科,450000

出　　处：《骨科临床与研究杂志》2019年第1期32-37,共6页Journal Of Clinical Orthopedics And Research

基　　金：河南省科技创新杰出人才计划项目(154200510027)~~

摘　　要：目的探讨应用单侧Isobar TLL动态非融合内固定系统治疗腰椎间盘突出症的临床效果。方法回顾分析2012年2月至2015年6月郑州大学附属人民医院行单侧Isobar TLL动态内固定术的40例腰椎间盘突出症患者的病历资料。观察并比较手术前后疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、日本骨科协会评分(JOA)、椎间隙高度、椎间活动度、腰椎前凸角、椎间盘退变UCLA分级以及改良Pfirrmann分级。结果随访时间为(53. 6±32. 3)个月。术后24个月,VAS评分及ODI指数较术前均明显降低(P <0. 05),JOA评分较术前明显升高(P=0. 013)。术后椎间隙高度较术前无明显变化(P> 0. 05),相邻上节段椎间活动度较术前明显增加(P <0. 05),固定节段活动度较术前减小(P <0. 05),腰椎前凸角无明显变化(P=0. 100)。手术前后椎间盘退变UCLA分级和改良Pfirrmann分级差异无统计学意义(P> 0. 05),结论应用单侧Isobar TLL动态非融合内固定系统治疗腰椎间盘突出症的临床效果令人满意,具有手术创伤小、费用低及患者恢复快等优势。Objective To evaluate the clinical effect of unilateral Isobar TLL dynamic fixation system in treatment of lumbar disc herniation.Methods A total of 40 cases with lumbar disc herniation unilateral Isobar TLL dynamic fixation in Affiliated People's Hospital of Zhengzhou University from February 2012 to June 2015 were retrospectively analyzed.The visual analogue scale(VAS),Oswestry disability index(ODI),Japanese Orthopaedic Association(JOA)scores,disc height,range of motion,lumbar lordosis angle,grading scale of University of California at Los Angeles(UCLA)and modified Pfirrmmann grading system of disc degeneration were observed and compared on preoperative and postoperative.Results The follow-up time was(53.6±32.3)months.At the last follow-up,the VAS score and ODI index were significantly lower than those preoperative(P<0.05),JOA score was significantly higher than that preoperative(P=0.013).The disc height was no significant difference between preoperative and postoperative(P>0.05).The intervertebral motion in the adjacent upper segment increased significantly(P<0.05),while fixed segment mobility decreased after surgery(P<0.05).The lumbar lordosis angle was no significance(P=0.100).The UCLA grading scale and modified Pfirrmmann grading were no statistical significances between preoperative and postoperative(P>0.05).Conclusion The clinical effect of lumbar disc herniation treated with the unilateral Isobar TLL dynamic non-fusion internal fixation system is satisfactory,with the advantages of less surgical trauma,low cost and rapidly recovery of patients.

关 键 词：腰椎 椎间盘移位 椎关节突关节 动态非融合内固定系统 单边动态稳定 

分 类 号：R687.3[医药卫生—骨科学]