摘要
背景:针对动态内固定系统短期临床疗效及能否延缓腰椎治疗后邻近节段退变的问题,临床上存在争议。目的:探究单节段Isobar TTL系统动态内固定治疗腰椎退行性疾病的短期临床疗效。方法:回顾性分析了使用单节段Isobar TTL内固定并按时间进行随访的20例患者资料,其中男11例,女9例,平均年龄47.4岁(35-62)岁,使用目测类比评分、日本骨科协会评估治疗评分、Oswestry功能障碍指数评估临床疗效,在X射线片上测量动态固定节段及其上相邻节段的椎间隙高度、椎间活动度,使用UCLA系统评估动态固定节段及相应的上相邻节段的椎间盘退变情况。结果与结论:随访患者均顺利完成手术,平均随访时间为14.4个月(12-27个月)。未出现血管、神经损伤、内固定松动、断裂等并发症。20例患者末次随访时目测类比评分、日本骨科协会评估治疗评分及Oswestry功能障碍指数较治疗前有明显改善(P<0.05),末次随访时动态固定节段活动度较治疗前减小(P<0.05),动态固定节段椎间隙高度及UCLA分级与治疗前相比差异无显著性意义(P>0.05),上相邻节段椎间隙高度、椎间活动度及椎间盘UCLA分级较治疗前差异无显著性意义(P>0.05)。提示单节段Isobar TTL动态内固定治疗腰椎退行性疾病疗效满意,短期随访期间未出现动态固定节段及邻近节段椎间盘退变加重现象。
BACKGROUND:The short-term effects of dynamic internal fixation and whether dynamic internal fixation system can prevent or delay the process of adjacent level degeneration after lumbar surgery remain in controversy.OBJECTIVE:To investigate the short-term clinical effectiveness of single-level Isobar TTL dynamic internal fixation in the treatment of degenerative lumbar diseases.METHODS:Data of 20 patients who suffered from lumbar degenerative diseases and underwent posterior decompression combined with single-level Isobar TTL dynamic internal fixation,including 11 male patients and 9 female patients,were retrospectively analyzed;the average age of these patients was 47.4(35-62)years old.Visual analog scale,Japanese Orthopaedic Association scores and Oswestry disability index were used to assess clinical outcomes.Disc height,range of motion,and University of California at Los Angeles Grading Scale were measured on X-ray films to evaluate the status of disc degeneration on both dynamic fixed segment(index segment)and superior adjacent segment.RESULTS AND CONCLUSION:All follow-up patients successfully completed the operation.The average follow-up time was 14.4(12-27)months.No blood vessels,nerve injury,loose internal fixation or rupture occurred.At the last follow-up,Visual Analog Scale,Japanese Orthopaedic Association scores and Oswestry Disability Index were significantly improved(P<0.05);range of motion of dynamic fixation segment reduced(P<0.05)as compared with that before surgery.Intervertebral height of dynamic fixation segments and University of California at Los Angeles Grading Scale classification were not significantly different between follow-up and before surgery(P>0.05).Intervertebral height of superior adjacent segment,intervertebral range of motion and University of California at Los Angeles Grading Scale classification were not significantly different(P>0.05).These results indicate that single-level Isobar TTL dynamic internal fixation proved to have satisfactory clinical outcomes in the treatment of lumbar degenerative diseases.During follow-up,disc degeneration on either index segment or superior adjacent segment is not accelerated.
作者
田一星
包肇华
邹俊
季一鸣
梅昕
潘俊
何文野
杨惠林
Tian Yi-xing;Bao Zhao-hua;Zou Jun;Ji Yi-ming;Mei Xin;Pan Jun;He Wen-ye;Yang Hui-lin(Department of Orthopedics,First Affiliated Hospital,Soochow University,Suzhou 215006,Jiangsu Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2018年第7期1020-1025,共6页
Chinese Journal of Tissue Engineering Research
基金
国家自然科学基金项目(81472132)~~
关键词
内固定器
椎间盘退化
脊柱融合术
Internal Fixators
Intervertebral Disk Degeneration
Spinal Fusion
