IntraSPINE动态固定在腰椎间突出症的临床应用
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1.河南省人民医院;2.郑州市骨科医院

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A clinical comparison study of discectomy and discectomy plus IntraSPINE interlaminar dynamic stabilization system for lumbar disc herniation
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1.Henan provincial people’s hospital;2.Zhengzhou Orthopedics Hospital

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    摘要:

    目的 通过单纯髓核摘除术与髓核摘除联合IntraSPINE动态固定治疗腰椎间盘突出症的临床疗效和影像学对比研究,评估IntraSPINE动态固定在治疗腰椎间盘突出症5年以上随访的临床疗效。方法 2013年1月至2014年5月,分别采用单纯髓核摘除术和髓核摘除辅助IntraSPINE动态固定治疗腰椎间盘突出症112例,通过视觉模拟量表(VAS)、 Oswestry功能障碍指数(ODI)评分评价术前和术后随访的临床疗效;观察椎间隙高度(ISH)、椎间孔高度(FH)和椎间孔宽度(FW)变化,统计复发情况。结果 动态固定组手术时间(80.18±11.68)min,较未固定组(69.11±17.61)min长,差异有统计学意义(P=0.001)。两组患者术后VAS评分、ODI评分均较术前显著改善,差异有统计学意义。动态固定组终末随访腰部VAS评分(2.16±0.71)低于未固定组(2.66±1.13),差异有统计学意义(P=0.001)。动态固定组终末随访椎间隙高度(9.21±0.89mm)高于术前高度(8.41±1.25mm),差异有统计学意义(P=0.000)。未固定组终末随访椎间隙高度(7.95±1.03mm)低于术前高度(8.35±1.07mm),差异有统计学意义(P=0.044)。动态固定组的椎间孔高度在术后随访高于未固定组(P=0.000)。动态固定组发生迟发性感染1例,行内固定取出并清创;椎间盘突出复发1例,未行手术治疗。未固定组椎间盘突出复发5例,行手术治疗3例。结论 IntraSPINE动态固定治疗腰椎间盘突出症在5年以上中期随访中临床疗效显著,降低了慢性腰痛的发生,增加并维持了椎间隙高度和椎间孔高度,减少了复发。

    Abstract:

    【Abstract】Objective To evaluate the clinical outcomes and the radiography change of IntraSPINE interlaminar dynamic stabilization system in the treatment of lumbar disc herniation.Methods During January 2013 to May 2014,56 patients were treated by surgery of discectomy and discectomy plus IntraSPINE and 56 patients were treated by surgery of discectomy.VAS score and Oswestry disability index were performed.The intervertebral space height,the foramen height and the foraminal width with X-ray were observed. Results The operation time of the dynamic stabilization group was longer than the discectomy group,and the difference was statistically significant (P=0.001).Both groups received significant improvement of VAS and ODI. There was significant statistics differenee in the VAS-B between both groups at final follow-up.There was significant statistics differenee in the ISH and FH at follow-up when compared to those of the preoperative data. 1 case occurred delayed infection in the dynamic stabilization group, and debridement was performed.1 case of disc herniation recurred but without surgical treatment. 5 cases of disc herniation recurred in discectomy group, 3 cases underwent surgical treatment.Conclusions The IntraSPINE interlaminar dynamic stabilization system is effective in the treatment of degenerative lumbar spine disease,which can reduce the incidence of chronic low back pain,inerease intervertebral space height and reduce recurrence rate.

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  • 收稿日期:2019-10-16
  • 最后修改日期:2019-11-25
  • 录用日期:2019-12-06
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