Isobar动态内固定系统治疗两节段腰椎退行性病变的疗效  

Effect of the Isobar dynamic stabilization system for treatment of two-segment lumbar degenerative disease

作　　者：张快强 杨利学 谭龙旺 孙智平 董琪 ZHANG Kuai-qiang;YANG Li-xue;TAN Long-wang;SUN Zhi-ping;DONG Qi(Dept of Spine Surgery,the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang,Shaanxi 712000,China)

机构地区：[1]陕西中医药大学附属医院脊柱科

出　　处：《临床骨科杂志》2019年第5期542-545,共4页Journal of Clinical Orthopaedics

基　　金：陕西省重点科技创新团队(编号:2013KCT-26)

摘　　要：目的探讨Isobar动态内固定系统治疗两节段腰椎退行性病变的临床疗效。方法 对37例两节段腰椎退行性病变患者行责任椎间隙髓核摘除、椎间融合器置入,Isobar动态内固定系统对责任椎间隙行绝对固定,相邻椎间隙利用该系统的微动弹簧部分行弹性固定。采用VAS评分和ODI评定疼痛和功能情况,测量术前、术后3个月及术后1年弹性固定椎间隙前缘和后缘高度,评估相邻椎间退变情况。结果 37例均获得随访,时间6~36个月。术后1、3、6个月及末次随访VAS评分、ODI均较术前明显改善,差异均有统计学意义(P<0.05)。17例影像学评估结果:弹性固定节段椎间隙前缘高度术后1年与术前、术后3个月比较差异有统计学意义(P<0.05);椎间隙后缘高度术后1年与术前、术后3个月比较差异无统计学意义(P>0.05);提示未见邻近节段退行性病变加重。结论 Isobar动态内固定治疗两节段腰椎退行性病变,在保证椎间融合同时,预防和减少了相邻节段椎间盘的退变,近期效果满意。Objective To investigate clinical effect of Isobar dynamic internal fixation system in the treatment of two-segment lumbar degenerative diseases. Methods The 37 patients with two-segment lumbar degeneration disease were treated with nucleus pulposus removal of responsibility intervertebral space and intervertebral fusion cage placement,and the responsibility intervertebral space was absolutely fixed by using the Isobar dynamic system.The adjacent intervertebral space was fixed by the micro elastic system.The therapeutic effect was evaluated by pain VAS and ODI score.The changes of the anterior and posterior edge height of the elastic fixation intervertebral space before the surgery,3 months and 1 year after the surgery were measured to evaluate the intervertebral degeneration. Results All 37 patients were followed up for 6~36 months.At postoperative 1,3,6 months and the final follow-up,the VAS and ODI scores were significantly improved compared with those before surgery,and the differences were statistically significant ( P <0.05).The imaging evaluation results of 17 cases:there were significant differences in the anterior edge height of intervertebral space with elastic fixation segment between 1 year after surgery and the preoperation,3 months after surgerys( P <0.05),there were no significant differences in the posterior edge height of the intervertebral space between the preoperation,3 months postoperation and at 1 year after surgery ( P >0.05),which suggested that there was no deterioration in the adjacent segment. Conclusions Isobar dynamic internal fixation can prevent and reduce the degeneration of adjacent intervertebral discs while ensuring intervertebral fusion.The short-term results are satisfactory.

关 键 词：Isobar动态内固定系统 双节段腰椎退行性病变 脊柱融合 非融合 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]