K-ROD系统治疗腰椎间盘突出伴相邻节段退变的疗效  

The efficacy of K-ROD system in the treatment of lumbar disc herniation with adjacent segment degeneration

作　　者：程学良 曲扬[1] 董荣鹏[1] 康明阳[1] 赵建武[1] CHENG Xue-liang;QU Yang;DONG Rong-peng;KANG Ming-yang;ZHAO Jian-wu(Diagnosis and Treatment Center,Dept of Orthopaedics,the Second Hospital of Jilin University,Changchun,Jilin 130041,China)

机构地区：[1]吉林大学第二医院骨科诊疗中心,吉林长春130041

出　　处：《临床骨科杂志》2021年第2期178-183,共6页Journal of Clinical Orthopaedics

基　　金：吉林省科技厅重点科技攻关项目(编号:20170204031YY)。

摘　　要：目的探讨K-ROD系统治疗腰椎间盘突出伴相邻节段退变的临床疗效。方法将20例腰椎间盘突出伴相邻节段退变的患者按照手术方式的不同分为观察组(采用K-ROD系统治疗,11例)和对照组(采用单节段后路椎体间融合治疗,9例)。观察两组手术情况、临床疗效(腰、腿部疼痛VAS评分和功能障碍指数)和影像学指标(椎间隙高度和椎间活动度)。结果患者均获得随访,观察组随访时间34~53(44.55±6.52)个月,对照组随访时间31~54(40.22±9.26)个月。①手术时间、术中出血量观察组明显长(多)于对照组(P<0.05)。②临床疗效:术后1年、末次随访时两组均较术前明显改善(P<0.05);末次随访时观察组各项指标均明显优于对照组(P<0.05)。③影像学指标:术后1年椎间隙高度两组比较差异无统计学意义(P>0.05),末次随访时观察组椎间隙高度明显高于对照组(P<0.05);术后1年、末次随访时与术前比较,观察组退变椎间盘节段椎间活动度(ROM 1)均降低(P<0.05),退变椎间盘上位相邻节段椎间活动度(ROM 2)均增高(P<0.05),对照组ROM 1、ROM 2均增高(P<0.05),ROM 1两组间比较差异均有统计学意义(P<0.05)。末次随访时出现邻椎退变观察组1例、对照组7例,两组比较差异有统计学意义(P<0.05)。结论K-ROD系统用于治疗腰椎间盘突出伴相邻节段退变临床疗效较好,可延缓手术相邻节段椎间盘的退变。Objective To investigate the clinical efficacy of K-ROD system in the treatment of lumbar disc herniation with adjacent segment degeneration.Methods Twenty patients who suffered from lumbar disc herniation with adjacent segment degeneration were divided into observation group(using K-ROD system,11 cases)and control group(adopting single segment posterior lumbar interbody fusion,9 cases),according to the different operation method.The operation situation,clinical efficacy(VAS of lumbar spine and leg pain,Oswestry dysfunction index)and imaging parameter with the height of intervertebral space and range of motion(ROM)of the intervertebral body in the two groups were observed.Results All patients were followed up,the time was 34~53(44.55±6.52)months in the observation group,and 31~54(40.22±9.26)months in the control group.①The operation time and intraoperative blood loss in the observation group were significantly longer(more)than those in the control group(P<0.05).②The clinical efficacy:at postoperative 1 year and the last follow-up,which were significantly improved than the preoperation(P<0.05);and the various indexes of observation group was significantly better than the control group at the last follow-up(P<0.05).③The imaging index:for the intervertebral space height,which had had no statistical difference between two groups at postoperative 1 year(P>0.05),and the observation group was higher than the control group at the last follow-up(P<0.05);at posteroperative 1 year and last follow-up,in the observation group,intervertebral disc ROM 1 of the degeneration intervertebral disc segement was decreased(P<0.05),and intervertebral disc ROM 2 of degeneration intervertebral disc upper adjacent segement was increased(P<0.05);ROM 1 and ROM 2 in the control group were both increased(P<0.05);there was difference for ROM 1 between two groups(P<0.05).At the last follow-up,there were 1 case of ajecant vertebral degeneration in the observation group,and 7 cases of adjacent verbebral degeneration in the control group,th

关 键 词：K-ROD系统 腰椎后路椎间融合 腰椎间盘突出 

分 类 号：R681.57[医药卫生—骨科学] R687.3[医药卫生—外科学]