摘要
[目的]对人工腰椎间盘置换术的疗效进行临床和影像学评价。[方法]自1998年9月～2007年12月,应用SBCharit啨Ⅲ型假体对29例患者施行人工腰椎间盘置换术,对其中获得平均6.9年(3～9年)随访的26例30个节段假体进行疗效评价分析。26例患者中,男25例,女1例;平均年龄44.2岁(38～59岁);腰椎间盘退变性病变3例,腰椎间盘退变合并腰椎间盘突出症21例,腰椎间盘突出术后复发2例。VAS疼痛评分术前平均9.1分,Oswes-ty功能评分术前平均46.4分。所有患者均在全身麻醉下经腹壁前路行人工腰椎间盘置换术。22例行单节段置换,其中L4、58例、L4、5,L5S116例;二节段4例,均为L4、5和L5S1。本组分别在术前和术后1、3、6、12个月及末次随访时进行疗效分析。[结果]疼痛VAS评分:术后1、3、6和12个月分别为3.7、3.2、3.0和2.5分,2年时2.3分,末次随访时2.0分;Oswesty功能评分:术后1个月27.7分,术后3年9.7分,末次随访时7.4分,活动度:末次随访时1例活动度减小(<4°),其余患者均有活动度,平均5.6°。所有患者术后无假体移位、松动和下沉;1例患者术后尚满意,总满意率96%。[结论]人工腰椎间盘置换术是治疗腰椎间盘退变的有效方法。
[ Objective] To evaluate the clinical and radiographic results of total lumbar disc replacement with SB Charite prosthesis. [ Methods] From Sep. 1998 to Dec. 2007, total lumbar disc replacement with SB Charite Ⅲ prosthesis was performed in 29 patients with degenerative lumbar disc disorders. Among these patients, 26 （ 30 prosthesis） were followed - up for more than 3 years （3 to 9 years） . There were 25 males and one female with an average age of 44. 2 years （range, 38 to 59 years） . The diagnosis was lumbar disc herniation with low back pain in 21 patients, discogenic low back pain in 3 patients and failed lumbar disc surgery in 2 patients. All patients underwent standard anterior procedure under general anesthesia. One level replacement was done in 22 patients （L4.5 and L5S1 ） . Clinical and radiograthic results of these patients were evaluated at each follow- up time （at 1, 3, 6, 12 months after operation and the latest） . [ Results] The average visual analogue scale score （VAS） for pain was 9. 1 before operation, 3.7 one month after opertion, 2. 5 three years after operation and 2. 0 at the last fol- low - up evaluation. Meanwhile, the average Oswestry Disability Index was 46. 4 before operation, 27.7 one month and 9. 7 three years after operation, and 7.4 at the last follow - up evaluation. All operated levels but one were not mobile and three had no significant loss of range of motion. Complications such as implant dislocation or significant subsidence of the prosthesis occurred in none of this group, but one had bleeding. The overall patient satisfaction with the results at the last follow - up was 96%. [ Conclusion] Total lumar disc replacement is an effctive method for the treatment of degenerative disc disorders. Its long -term outcome remains to be verified.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2010年第13期1071-1073,共3页
Orthopedic Journal of China
关键词
椎间盘
腰椎
假体和植入物
intertebral disk, lumbar, prosthesis and implants
