K-Rod动态稳定系统治疗腰椎退行性疾病的中期疗效  

Mid-term efficacy of K-Rod dynamic stabilization system in the treatment of lumbar degenerative diseases

作　　者：普有登[1] 杨俊宇 周兆文[1] 段洪[1] 尹劲[1] 孙启增 金雄[1] 张涵[1] 蓝天[1] Pu Youdeng;Yang Junyu;Zhou Zhaowen;Duan Hong;Yin Jin;Sun Qizeng;Jin Xiong;Zhang Han;Lan Tian(Department of Orthopedics,The First People's Hospital of Kunming,Kunming Yunnan,650000,China)

机构地区：[1]昆明市第一人民医院骨科,云南昆明650000

出　　处：《生物骨科材料与临床研究》2021年第3期42-48,53,共8页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨K-Rod动态稳定系统治疗腰椎退行性疾病的中期疗效及其对邻近上位节段的影响。方法回顾性分析昆明市第一人民医院骨科2011年2月至2013年6月65例采用K-Rod动态稳定系统治疗腰椎退行性疾病患者的临床资料。其中,男31例,女34例,年龄21~73岁,平均(53.4±10.8)岁;融合组(n=21),非融合组(n=20),“融合+非融合”组(n=24)。记录术中失血量、手术时间、住院时间及并发症;根据术前及各随访时间腰痛、下肢痛VAS评分,ODI评分评价临床疗效。比较3组病例术前及随访时间腰椎侧位X线片、腰椎MRI手术及邻近上位节段椎间隙高度、椎间盘退变Pfirrmann's分级情况。结果经72~84个月,平均(72.0±8.6)个月随访。3组组内术后3、6个月及末次随访时腰痛、下肢痛VAS评分及ODI评分与术前比较,差异均有统计学意义(P<0.05)。末次随访时,腰痛、下肢痛VAS评分改善率,融合组为66.4%、76.7%,非融合组为84.4%、72.4%,“融合+非融合”组为70.8%、77.8%;邻近上位节段椎间盘退变Pfirrmann's分级:非融合组、“融合+非融合”组与术前比较差异无统计学意义(P>0.05),融合组与术前比较差异有统计学意义(P<0.05)。手术节段椎间高度指数:3组组内术后1周与术前比较,差异有统计学意义(P<0.05),术后3个月、6个月、末次随访时与术后1周比较差异无统计学意义(P>0.05)。邻近节段椎间高度指数:非融合组、“融合+非融合”组术后1周、3个月、6个月、末次随访时与术前比较,差异无统计学意义(P>0.05);融合组末次随访与术前比较,差异有统计学意义(P<0.05)。结论应用K-Rod动态稳定系统对腰椎退行性疾病行非融合及“非融合+融合”术治疗,中期随访疗效良好,一定程度上可延缓邻近节段椎间盘退变,对退变的椎间盘有一定的保护作用。Objective To investigate the mid-term efficacy of K-Rod dynamic stabilization system in the treatment of lumbar degenerative diseases and its effect on adjacent superior segments.Methods The clinical data of 65 patients with lumbar degenerative diseases treated with K-Rod dynamic stabilization system in the First People's Hospital of Kunming from February 2011 to June 2013 were analyzed retrospectively.Among them,there were 31 males and 34 females,aged from 21 to 73 years old,with an average of(53.4±10.8)years;there were 21 cases in the fusion group,20 cases in the non-fusion group and 24 cases in the"fusion+non-fusion"group.The intraoperative blood loss,operation time,hospital stay and complications were recorded,and the clinical effect was evaluated according to the VAS score of low back pain and lower limb pain and ODI score before operation and at each follow-up time.The preoperative and follow-up X-ray films of lumbar vertebrae,MRI operation of lumbar vertebrae,height of intervertebral space of adjacent superior segments and Pfirrmann's grade of intervertebral disc degeneration were compared among the three groups.Results After 72-84 months,with an average of(72.0±8.6)months follow-up,there were statistically significant differences in the VAS scores of low back pain and lower limb pain and ODI scores at 3 and 6 months after surgery and the last follow-up in the 3 groups compared with those before surgery(P<0.05).At the last follow-up,the improvement rates of VAS scores of low back pain and lower limb pain in fusion group,non-fusion group and"fusion+non-fusion"group were(66.4%,76.7%),(84.4%,72.4%),(70.8%,77.8%),respectively.Pfirrmann's grade of adjacent superior intervertebral disc degeneration:there was no significant difference between the non-fusion group and the"fusion+non-fusion"group,but there was significant difference between the fusion group and the preoperative group(P<0.05).Operative segment intervertebral height index:There was significant difference between 1 week after operation and before op

关 键 词：K-Rod动态稳定系统 腰椎退行性疾病 动态稳定 邻近节段退变 中期随访 

分 类 号：R681.5[医药卫生—骨科学]