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Isobar非融合内固定系统治疗腰椎退行性疾病的早期疗效分析
刘明1,勘武生1,李鹏1,何大为2*
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(1. 华中科技大学同济医学院附属普爱医院脊柱外科,武汉 430033;2. 第二军医大学长海医院骨科,上海 200433)
摘要:
目的评价Isobar非融合内固定系统治疗腰椎退行性疾病的早期疗效。 方法2007年5月至2009年5月,对35例腰椎退行性疾病患者行后路减压术后应用Isobar非融合内固定系统进行固定。比较患者手术前后的腰腿痛视觉模拟评分(visual analogue scale, VAS)、汉化的Oswestry功能障碍指数(Oswestry disability Index, ODI)、整个腰椎及动态固定节段的活动度(range of motion, ROM),对手术疗效进行评价。 结果患者均获随访,随访时间12~36个月,平均18个月。术后1年,患者临床症状改善明显。腰腿痛VAS评分由术前的6.45±1.71恢复至2.12±1.42(P<0.001);ODI由术前(76.50%±15.93%)恢复至(21.13%±17.24%)(P<0.001)。腰椎及动态固定节段ROM手术前、后差异无统计学意义。1例在术后3年发生螺钉松动,无临床症状。结论应用Isobar非融合内固定系统治疗腰椎退行性疾病早期疗效满意,其能保留固定节段一定活动度,是一种可取的治疗方法。
关键词:  腰椎退行性疾病  减压  非融合内固定
DOI:10.3724/SP.J.1008.2011.0455
投稿时间:2010-10-31修订日期:2011-01-28
基金项目:
Isobar non-fusion internal fixation system in treatment of lumbar degenerative diseases: an analysis of preliminary outcome
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Abstract:
[Abstract] Objective To evaluate the preliminary clinical results of Isobar non-fusion internal fixation in treatment of lumbar degeneration disease. Methods From May 2007 to May 2009, 35 cases of lumbar degeneration disease were surgically treated by posterior decompression with Isobar non-fusion internal fixation. The clinical results were assessed by visual analogue scale (VAS) for back and leg pain and Chinese version of Oswestry disability index (ODI), as well as range of motion (ROM) of total lumbar and dynamic fixation segment. Results The follow-up duration was 18 months on average (range,12 to 36 months). All clinical symptoms of the patients were notably improved. One patient experienced a loosened screw at three years after surgery, but no clinical symptom. The mean VAS for back and leg pain was 6.45 before operation, and decreased significantly to 2.12 one year after surgery(P<0.001); The mean ODI score was 76.50% before operation, and also recovered significantly to 21.13% one year post-operation(P<0.001). There were no significant differences in the ROM of total lumbar and dynamic fixation segment before and after operation (P>0.05). Conclusion Preliminary clinical results of Isobar non-fusion internal fixation in treatment of degenerative lumbar disease were satisfying. This kind dynamic stabilization system preserves the motion of fixation segment and provides an alternative for treatment of lumbar degenerative disease.
Key words:  lumbar degeneration disease  decompression  Non-fusion interal fixation