基于PEEK棒系统的Hybrid术式在腰椎退变性疾病中的临床应用观察
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宁夏人民医院

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银川市2017医疗卫生科研攻关项目


Clinical application and preliminary outcome analysis of PEEK rod dynamic stabilization system combine with hybrid surgery in treatment of lumbar degenerative diseases.
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1.Ningxia People'2.'3.s Hospital

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    摘要:

    摘 要】目的: 探讨基于PEEK(polyetheretherketone,PEEK)棒系统的hybrid术式在腰椎退变性疾病的临床应用及疗效。 方法: 回顾性分析我院自 2015年3月- 2017年6月收治并符合纳入标准的腰椎退变性疾病患者临床资料。男8例,女12例;年龄55~83岁,平均68.2岁;病变节段为L3~S1。患者均采用PEEK棒内固系统进行融合与非融合结合的hybrid术式接受手术治疗。采用疼痛视觉模拟评分(VAS)、Oswestry 功能障碍指数(ODI)评分评价患者症状改善情况,Stauffer-Coventry 评价标准进行临床疗效评价。测量术前、术后6个月及末次随访时手术固定节段近端临近椎间隙高度(disc space height,DSH)、活动范围(range of motion,ROM),评价邻椎间隙退变情况。结果:20例患者随访时间 12~39个月,平均18.5个月。手术切口均Ⅰ期愈合。术后6个月及末次随访时,VAS、ODI评分均较术前明显改善(P<0.001)。末次随访时,根据 Stauffer-Coventry 评价标准,临床疗效评价优15例,良3例,中2例,差 0 例,优良率为90%。术后无内固定断裂、松动及神经功能损伤等相关并发症发生。术后6月及末次随访时邻近节段DSH、ROM与术前比较,差异均无统计学意义(P>0.05)。结论: PEEK棒内固定系统联合应用hybrid术式治疗腰椎退变性疾病临床早期疗效满意。为老年腰椎退行性疾病的手术治疗提供了新的选择,尤其是多节段腰椎退变性疾病,手术时间更短、出血更少、创伤更小;但其长期效果仍需进一步进行临床对照研究。

    Abstract:

    【Abstract】Objective: To explore clinical application and preliminary outcome analysis of PEEK(polyetheretherketone,PEEK) rod dynamic stabilization system combined with hybrid surgery in treatment of lumbar degenerative diseases. Methods: Retrospective analysis the clinical data of patients with lumbar degenerative diseases admitted to our hospital from March 2014 to June 2017.Including 8 males and 12 females with an average age of 68.2 years (range 55-83 years) , the disease level is from L3 to S1.Surgical procedures including hybrid surgery and dynamic stabilization with PEEK rod system were performed. The VAS, ODI and Stauffer-Coventry value standard were scored to evaluate the clinical efficacy. Range of motion (ROMs) , disc space height(DSH)of each adjacent instrumented levels(one segment above the instrumentation )were measured before and after operation to evaluate the degeneration of adjacent disk .Results: The average follow up period was 12-39 months (average18.5months). All the incisions healed by first intention. The scores of VAS and ODI were significantly improved at 6 months and at the end of follow-up (P<0.001). At the last follow-up, according to Stauffer-Coventry evaluation criteria, clinical efficacy was excellent in 15 cases, good in 3 cases, medium in 2 case, poor in 0 cases, the excellent and good rate was 90%. No postoperative complications such as internal fixation fracture, loosening and neurological impairment occurred. There was no significant difference in DSH and ROM between adjacent segments 6 months after operation and at the last follow-up (P > 0.05). Conclusions: PEEK rod dynamic stabilization system combined with hybrid surgery in the treatment of lumbar degenerative diseases with satisfactory early clinical results. It provides a new choice for the surgical treatment of senile lumbar degenerative diseases, especially multi-level lumbar degenerative diseases, with shorter operation time, less bleeding and less trauma, but its long-term effect still needs further clinical control study.

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  • 收稿日期:2019-02-23
  • 最后修改日期:2019-04-11
  • 录用日期:2019-04-25
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