摘要
目的 评估后路非融合固定（Graf技术）应用于腰椎间盘退变性疾病的疗效。方法分析13例非融合固定（A组）和21例融合固定（B组）治疗单节段腰椎退行性病变的临床和影像学资料。视觉模拟评分（VAS）、日本整形外科学会（JOA）评分和ODI功能评价评估临床疗效，腰椎过伸和过屈、侧位X线片评估腰椎活动度和腰椎前凸角（Cobbs法），观察两组手术并发症。结果 平均随访19个月（12～29个月），末次随访A、B两组VAS评分分别由术前9．4、9．1分减少到2．1、3．6分；JOA评分均显著优于术前（P〈0．001），两组无显著性差异（P〉0．05）；A组术后ODI优良率93％，B组71％，A组显著优于B组（P〈0．05）。结论 后路非融合固定是治疗腰椎间盘退变性疾病的有效方法，与融合固定相比，可以获得满意的临床疗效和保留一定的腰椎活动度。
Objective To assess the efficacy of posterior dynamic fixation- Graf ligamentoplasty comparison with rigid fixation for the degenerative disc disease. Methods The clinical and radiographic results of 13 patients with dynamic fixation and 21 patients with rigid instrumentation for onelevel lumbar degenerative disc disease were evaluated. Visual analogue pain scale （VAS, 10 points）, Japanese orthopeadic association （JOA, 29 points）, and Oswestry disability index （ODI） were used for clinical evaluation. Cobbs method was used for lumbar range of motion （ROM） measurement on dynamic lateral X- ray films. Complications related to operation were also considered. Results The follow - up period ranged from 12 to 29 months （average 19 months）. The pre - operative and post - operative VAS was 9. 4 （A） /9.1 （B） and 2.1 （A） /3.6 （B） respectively. The mean JOA score at the final follow - up was significantly higher than the pre - operative score （ P 〈 0. 001）. There was no significant difference between group A and B （ P 〉 0.05）. Group A patients had a satisfactory outcome compared to group B measured by ODI （P 〈 0.05）. Conclusion The stabilization by Graf ligamentoplasty has some advantages over lumbar fusion by rigid fixation regarding clinical results and lumbar ROM. It is a worthwhile procedure for one level degenerative disc disease if the patients are selected properly.
出处
《中国骨与关节损伤杂志》
2008年第6期453-455,共3页
Chinese Journal of Bone and Joint Injury
