摘要
目的比较 Dynesys 系统治疗单节段与多节段腰椎退变性疾病的临床疗效。方法回顾分析2008年7月至2011年3月采用 Dynesys 系统治疗的腰椎退变疾病患者46例。根据患者手术节段分为单节段组（32例）和多节段组（14例）。记录两组患者术前术后 Oswestry 功能障碍指数（ oswestry disability index，ODI ）和疼痛视觉模拟量表（ visual analogue scale，VAS ）评分，摄腰椎正侧位和前屈后伸位片，测量手术节段椎间高度、活动度以及近端相邻节段的椎间活动度。结果46例患者平均随访30（24～52）个月，两组患者 ODI 指数术后3个月：单节段组（20.5±5.7）%，多节段组（21.2±9.8）%；末次随访：单节段组（12.2±4.3）%，多节段组（15.3±6.9）%，均较术前明显改善（ P＜0.05）；VAS 评分术后3个月：单节段组2.9±1.3，多节段组3.2±1.4；末次随访：单节段组1.4±0.3，多节段组1.6±0.4，均较术前明显改善（ P＜0.05）。末次随访时 ODI 与 VAS 评分两组间差异无统计学意义（ P＞0.05）。两组患者手术节段椎间高度术后3个月单节段组（11.3±2.7） mm，多节段组（11.1±2.0） mm；末次随访单节段组（10.8±3.1） mm，多节段组（10.3±2.2） mm，较术前均有所下降，但差异均无统计学意义（ P＞0.05）。手术节段的活动度在术后3个月单节段组（4.3±2.4）°，多节段组（4.6±2.7）°；末次随访单节段组（4.8±2.2）°，多节段组（5.3±2.0）° 均显著下降（ P＜0.05）。两组近端相邻节段活动度在术后3个月时单节段组（9.1±2.1）°，多节段组（8.5±1.8）°有所增加，但差异无统计学意义（ P＞0.05），仅在末次随访时单节段组（10.3±2.7）° 较术前显著增加，并且单节段组大于多节段组（9.1±3.0）° （ P＜0.05）。结论单节段与多节段 Dynesys 内固定治疗腰椎退变性疾病均能获得满意的短期临床疗效，并保留部分椎间活动度�
Objective To compare the clinical outcomes of the Dynesys system in the treatment of single- level and multi-level lumbar degenerative diseases. Methods The clinical data of 46 patients with lumbar degenerative diseases who were treated by the Dynesys system from July 2008 to March 2011 were retrospectively studied. All patients were divided into single-level group （ 32 patients ） and multiple-level group （ 14 patients ）. Clinical outcomes were evaluated using the oswestry disability index （ ODI ） and visual analogue scale （ VAS ） scores. Radiological evaluations included the disc height and range of motion （ ROM ） of stabilized segments and the intervertebral ROM of the upper adjacent segments by lumbar anteroposterior, lateral, flexion, and extension X-rays. Results The average follow-up period was 30 months （ range; 24-52 months ） for all the patients. The ODI and VAS scores were significantly improved in both groups 3 months after the surgery single-level： ODI （ 20.5±5.7 ） %, VAS 2.9±1.3; multievel： OD1 （ 21.2±9.8 ） %, VAS 3.2±1.4 and in the latest follow-up single-level： ODI （ 12.2±4.3 ） %, YAS 1.4±4.3; multi-level： ODI （ 15.3±6.9 ） %, VAS 1.6±0.4 （ P〈0.05 ）, which were not different between the 2 groups in the latest follow-up （ P〉0.05 ）. The disc height of stabilized segments was slightly decreased in both groups 3 months after the surgery single-level （ 11.3±2.7 ） mm, multi-level （ 11.1±2.0 ）mm and in the latest follow-up single-level （ 10.8±3.1 ） mm, multi-level （ 10.3±2.2 ） mm, but the differences were not statistically significant （P〉0.05）. The ROM of stabilized segments was significantly decreased in both groups 3 months after the surgery single-level （ 4.3±2.4 ） °, multi-level （ 4.6±2.7 ） ° and in the latest follow-up single-level （ 4.8±2.2 ） °, multi-level （ 5.3±2.0 ） ° （ P〈0.05 ）. The ROM of the upper adjacent segments was slightly increased in both groups 3 months after the s
出处
《中国骨与关节杂志》
CAS
2013年第6期308-312,共5页
Chinese Journal of Bone and Joint
关键词
椎间盘退行性变
腰椎
脊柱疾病
Dynesys系统
Intervertebral disc degeneration
Lumbar vertebrae
Spinal diseases
Dynesys syetem
