Coflex腰椎棘突间动态稳定系统与腰椎后路椎间融合内固定治疗单节段腰椎退行性疾病的疗效比较  

Comparative study of efficacy of Coflex lumbar interspinous dynamic stabilization system and lumbar posterior interbody fusion for treatment of single-segment lumbar degenerative diseases

作　　者：何明长[1] 陈志达[1] 肖莉莉 宋超 刘晖[1] 林斌[1] HE Ming-chang;CHEN Zhi-da;XIAO Li-li;SONG Chao;LIU Hui;LIN Bin(Department of Orthopaedics,the 909th Hospital of Joint Logistic Support Force(Dongnan Hospital of Xiamen University),Zhangzhou,Fujian 363000,China;不详)

机构地区：[1]联勤保障部队第九○九医院(厦门大学附属东南医院)全军骨科中心,福建漳州363000 [2]联勤保障部队第九○九医院(厦门大学附属东南医院)超声科,福建漳州363000

出　　处：《中国骨与关节损伤杂志》2022年第7期691-695,共5页Chinese Journal of Bone and Joint Injury

基　　金：原南京军区医学科技创新重点课题(12Z24);漳州市双创之星基金项目(漳财行指[2019]17号)。

摘　　要：目的比较Coflex腰椎棘突间动态稳定系统与腰椎后路椎间融合内固定(Posterior lumbar interbody fusion,PLIF)治疗单节段腰椎退行性疾病的临床疗效。方法回顾性分析自2007-06—2012-02诊治的90例单节段腰椎退行性疾病,45例采用Coflex腰椎棘突间动态稳定系统手术治疗(Coflex组),45例采用PLIF治疗(PLIF组)。比较两组手术时间、术中出血量、住院时间、邻近节段退行性改变发生率以及术前、术后3年、末次随访时的疼痛VAS评分、ODI指数,比较两组术前、末次随访时的椎间后方高度、椎间孔高度、椎间活动度、上位椎间活动度、下位椎间活动度。结果两组均顺利完成手术并获得至少5年的随访。Coflex组手术时间、术中出血量、住院时间较PLIF少,邻近节段退行性改变发生率较PLIF组低,差异有统计学意义(P<0.05)。两组术前、术后3年以及末次随访时的疼痛VAS评分、ODI指数比较差异无统计学意义(P>0.05)。末次随访时Coflex组手术节段椎间活动度较PLIF组大,上位椎间活动度较PLIF组小,差异有统计学意义(P<0.05);末次随访时两组椎间后方高度、椎间孔高度、下位椎间活动度比较差异无统计学意义(P>0.05)。末次随访时PLIF组椎间后方高度、下位椎间活动度较术前增加,两组手术节段椎间活动度较术前减小,上位椎间活动度较术前增加,差异有统计学意义(P<0.05)。结论Coflex腰椎棘突间动态稳定系统与PLIF治疗单节段腰椎退行性疾病均可以获得满意的长期临床疗效。与PLIF相比,Coflex腰椎棘突间动态稳定系统手术能更好地维持手术节段活动度,降低邻近节段退行性改变的发生率。Objective To compare the clinical efficacy of the Coflex lumbar interspinous dynamic stabilization system and posterior lumbar interbody fusion(PLIF)for the treatment of single-segment lumbar degenerative diseases.Methods From June2007 to February 2012,90 cases of single-segment lumbar degenerative diseases were retrospectively analyzed,45 cases were treated with Coflex lumbar interspinous process dynamic stabilization system(Coflex group),and 45 cases with PLIF(PLIF group).The operative time,intraoperative bleeding,hospital stay,incidence of degenerative changes in adjacent segments,pain VAS score and ODI index before and 3 years after surgery,and at the last follow-up were compared between the two groups.The posterior intervertebral height,foraminal height,intervertebral mobility,superior intervertebral mobility,and inferior intervertebral mobility were also compared between the two groups before surgery and at the last follow-up.Results Both groups were completed the surgery successfully and received at least 5 years of follow-up.the Coflex group had less operative time,intraoperative bleeding,and hospital stay than the PLIF group,the difference was statistically significant(P<0.05).The incidence of degenerative changes in adjacent segments was lower than that of the PLIF group,the difference was statistically significant(P<0.05).There was no statistically significant difference in the pain VAS score and ODI index between the two groups before surgery,3 years after surgery and at the last follow-up(P>0.05).The Coflex group had greater intervertebral mobility in the operated segment than the PLIF group at the final follow-up,and the superior intervertebral mobility was less than that of the PLIF group,the difference was statistically significant(P<0.05).The differences in posterior intervertebral height,foraminal height,and inferior intervertebral mobility between the two groups at the final follow-up had no significant differences(P>0.05).The posterior intervertebral height and inferior intervertebral mobility

关 键 词：腰椎退行性疾病 Coflex腰椎棘突间动态稳定系统 腰椎后路椎间融合内固定 减压 

分 类 号：R687.3[医药卫生—骨科学]