摘要
目的 探讨腰椎融合联合Coflex动态固定手术（topping-off）对腰椎矢状面平衡的影响,并分析其与临床疗效的相关性.方法 2008年8月-2012年8月,31例腰椎退变性疾病患者接受腰椎融合联合Coflex动态固定手术,在术前及末次随访时对所有患者进行疼痛视觉模拟量表（visual analogue scale,VAS）评分和Oswestry功能障碍指数（Oswestry disability index,ODI）,同时测量腰椎前凸角和骶骨倾斜角,进行统计学分析.结果 所有患者均获得6个月以上随访,末次随访时VAS评分和ODI均获得显著改善（P＜0.001）.末次随访时,腰椎前凸角与术前相比无明显变化（P＞0.05）,而骶骨倾斜角则显著增加（P＜0.05）.根据随访时间将所有患者分为3年以内组（A组）和3年以上组（B组）,与术前相比,末次随访时A组患者腰椎前凸角呈轻度增加趋势,但差异无统计学意义（P＞0.05）,骶骨倾斜角无显著变化（P＞0.05）;与术前相比,末次随访时B组患者的腰椎前凸角呈增加趋势,但差异无统计学意义（P＞0.05）,骶骨倾斜角则显著增加（P＜0.05）.各临床疗效评分与末次随访时腰椎前凸角和骶骨倾斜角测量结果无明显相关性.结论 腰椎融合联合Coflex动态固定手术治疗腰椎退变性疾病的近中期疗效较为满意,手术对腰椎矢状面平衡有一定保护作用.未发现术后临床疗效与矢状面平衡指标存在明显相关性.
Objective To assess the effect of spinal fusion combined with Coflex system on sagittal balance and its correla- tion with clinical results. Methods From August 2008 to August 2012, 31 patients diagnosed with lumbar degenerative disc disease underwent spinal fusion combined with Coflex system. Visual analogue scale （VAS） scores and Oswestry disability index （ODI） were evaluated preoperatively and at the final follow-up. Lumbar lordosis and sacral tilt were measured for all patients. Results All patents were followed up for more than 6 months. At the final follow-up, VAS score and ODI had sig- nificant improvement （P 〈 0. 001 ）. At the final follow-up, lumbar lordosis showed no significant difference compared to that of preoperatively （ P 〉0. 05 ）, but sacral tilt increased （ P 〈 0.05 ）. All patients were divided into less than 3 years group （Group A） and more than 3 years group （Group B ） oceording to follow-up time. At the final follow-up, lumbar lordosis showed a tendency of increase compared to preoperative data but without statistical difference （P 〉 0. 05 ） in Group A, and sacral tilt also showed no difference （ P 〉0. 05 ）. Compared to preoperative data, Group B showed no significant difference in lumbar lordosis （P 〉 0.05 ） but an increase of sacral tilt （ P 〈 0.05 ）. There was no obvious correlation between clinical parameters and lumbar lordosis or sacral tilt. Conclusion The short- and mid-term results of fusion combined with Coflex system for lumbar degenerative disc diseases are satisfying. The surgery had some protective effect on sagittal balance. No obvious correlation was found between clinical results and sagittal balance.
出处
《脊柱外科杂志》
2014年第1期1-4,共4页
Journal of Spinal Surgery
关键词
腰椎
脊椎疾病
脊柱融合术
假体和植入物
肌肉骨骼平衡
Lumbar vertebrae
Spinal diseases
Spinal fusion
Prostheses and implants
Musculoskeletal equilibrium
