摘要
目的:探讨腰椎人工髓核置换术的中期疗效。方法:我院于2002年6月～2003年12月应用腰椎人工髓核置换术(PDN)治疗腰椎间盘突出症患者40例,全部选用PDN假体后方入路单枚置入。术后5年随访25例。评价指标包括临床疗效评分、观察椎间隙高度变化、假体位置改变、软骨终板的破坏,同时统计并发症的发生情况。结果:术后5年手术效果优良率72.0%;Oswestry评分21%,LBOS评分6,VAS评分2.8。椎间隙高度R术后较术前增加28.2%,术后3～18月较术前增加2.86%,术后5年较术前降低31.4%;术后5年腰椎活动度(range of motion,ROM)为10.6°;并发症主要包括假体旋转(25例)、终板破坏(18例)、终板塌陷(2例);另有2例因持续腰痛行腰椎融合术。结论:腰椎人工髓核置换术可明显改善临床症状,但中、远期无法维持椎间隙高度,仍存在假体移位及终板破坏等严重并发症,其进一步开展需严格掌握手术适应证。
Objective： To evaluate the mid--term clinical results of prosthetic disc nucleus （PDN） replacement for lumbar disc herniation （LDH） so as to provide evidence for its further application. Methods： Forty patients with LDH were treated with PDN replacement of single prosthesis via posterior approach from June 2002 to December 2003. Twenty--five patients were followed up for 5 years successfully. The clinical scale, changes in intervertebral height and prosthetic location, damages of end plates and complications were observed to evaluate the clinical results. Results： The post--operative excellent rate at 5 years was 72.0%. The Oswestry scale was 21%, LBOS scale was 6, and the VAS scale was 2.8. The intervertebral height increased 28.2 % after PDN replacement compared with before the operation, and increased 2.86% at 3 - 18 months after PDN replacement and decreased 31.4% 5 years after PDN replacement. The range of lumbar motion was 10. 6%. The complications included prosthetic rotation （25 cases）, damage of end plates （18 cases）, and collapse of end plates （2 cases）. Two patients received lumbar fusion because of uncontrollable low back pain. Conclusion： PDN replacement largely improves clinical symptoms, but can not sustain the intervertebral height for mid-- or long--term. The main complications include displacement of prosthesis and damage of end plates. Thus, it＇s necessary to strictly keep the indications.
出处
《中国中医骨伤科杂志》
CAS
2009年第5期35-37,共3页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词
腰椎
人工髓核
置换
并发症
Lumbar vertebrae
Prosthetic disc nucleus
Replacement
Complications
