[1]杨峰 周峻 麻昊宁 移平 唐向盛 谭明生.半刚性内固定系统治疗腰椎退行性疾病的中远期疗效观察[J].中国中医骨伤科杂志,2021,29(03):36-41.
　YANG Feng ZHOU Jun MA Haoning YI Ping TANG Xiangsheng TAN Mingsheng.Observation of Medium and Long-Term Curative Effect of Semi-Rigid Internal Fixation System on the Treatment of Degenerative Diseases of Lumbar Spine[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(03):36-41.
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半刚性内固定系统治疗腰椎退行性疾病的中远期疗效观察()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年03期
页码:
36-41
栏目:
临床研究
出版日期:
2021-03-15

文章信息/Info

Title:
Observation of Medium and Long-Term Curative Effect of Semi-Rigid Internal Fixation System on the Treatment of Degenerative Diseases of Lumbar Spine
文章编号:
1005-0205(2021)03-0036-06
作者:
杨峰 周峻 麻昊宁 移平 唐向盛 谭明生
1中日友好医院骨科(北京,100029)2北京中医药大学研究生院△通信作者 E-mail:zrtanms@sina.com
Author(s):
YANG Feng ZHOU Jun MA Haoning YI Ping TANG Xiangsheng TAN Mingsheng
1Department of Orthopedics,China-Japan Friendship Hospital,Beijing 100029,China; 2Graduate School,Beijing University of Chinese Medicine,Beijing 100029,China.
关键词:
动态固定系统;  传统内固定;  腰椎退行性疾病;  中远期疗效
Keywords:
dynamic fixation system;  traditional internal fixation;  degenerative lumbar disease;  mid- and long-term efficacy
分类号:
R681.5
文献标志码:
A
摘要:
目的:观察半刚性内固定系统(Waveflex动态固定系统)治疗腰椎退行性疾病的中远期疗效,探讨其在腰椎退行性疾病治疗中的应用价值。方法:回顾性分析2011年1月至2013年12月收治的78例腰椎退行性疾病患者。观察组35例,男18例,女17例; 年龄29～62岁,平均年龄(39.31±8.51)岁; 病程11个月～7 a,平均(26.24±12.41)个月。对照组43例,男20例,女23例; 年龄27～64岁,平均年龄(40.55±9.41)岁; 病程10个月～7 a,平均(28.12±13.87)个月。两组患者均行3个月以上保守治疗无效后,根据患者及其家属意愿选择手术方式,观察组行Waveflex动态固定,对照组行传统内固定。观察术前、术后3个月、术后1 a、术后2 a和末次随访的VAS评分、ODI评分、JOA评分、椎间隙高度(DSH)、椎间角(IVA)、运动范围(ROM)、并发症和再手术情况。结果:两组患者基线数据差异无统计学意义(P>0.05),所有患者均安全完成手术。观察组并发症3例(8.57%),对照组并发症2例(4.65%),差异无统计学意义(P>0.05),两组患者并发症经过处理康复出院。两组患者均获得随访,随访时间5～8 a,平均6 a。两组患者术后临床症状均较术前明显改善,随访期间两组患者均未出现内固定松动、断裂等并发症。观察组术后有2例再次行手术治疗,对照组术后有11例再次行手术治疗,观察组小于对照组,两组间的差异有统计学意义(P<0.05)。两组患者术后各个随访时间点VAS评分、ODI评分、JOA评分均较术前有明显改善,差异有统计学意义(P<0.05); 两组患者术前与术后各个时间点的VAS评分、ODI评分及JOA评分组间比较差异无统计学意义(P>0.05)。两组患者邻近退变节段术前DSH,IVA,ROM组间差异无统计学意义(P>0.05); 术后各个时间点的DSH和IVA观察组均大于对照组,差异有统计学意义(P<0.05); 术后各个时间点的ROM观察组均小于对照组,差异有统计学意义(P<0.05)。结论:Waveflex动态固定系统在腰椎退行性疾病的治疗上获得满意的中远期疗效,能够明显延缓邻近节段退变,降低再手术率。
Abstract:
To observe the mid- and long-term effect of semi-rigid internal fixation system(Waveflex dynamic fixation system)on the treatment of degenerative diseases of the lumbar spine,and to explore its application value for degenerative diseases of the lumbar spine.Methods:A retrospective analysis of 78 patients with lumbar degenerative diseases from January 2011 to December 2013 was carried out.There were 35 cases in the observation group including 18 males and 17 females aged from 29 to 62 years old with an average age of(39.31±8.51)years old.It was 11 months to 7 years the course of diseases with an average of(26.24±12.41)months.There were 43 cases in the control group including 20 males and 23 females aged from 27 to 64 years old with an average age of(40.55±9.41)years old.It was 10 months to 7 years the course of disease with an average of(28.12±13.87)months.After the two groups of patients received regular conservative treatment for more than 3 months the operation method was selected according to the wishes of the patients and their families.The observation group received Waveflex dynamic fixation,and the control group received traditional internal fixation.The VAS score,ODI score,JOA score,disc space heigh(DSH), intervertebral angle(IVA),range of motion(ROM),complications and reoperation were observed before operation,3 months after operation,1 year after operation,2 years after operation and the last follow-up.Results:There was no statistical difference in baseline data between the two groups(P>0.05).All patients completed the operation safely.There were 3 complications(8.57%)in the observation group and 2 complications(4.65%)in the control group,there was no significant difference(P>0.05).The patients in the two groups were discharged after treatment and rehabilitation.Patients in both groups were followed up for 5 to 8 years with an average of 6 years.The two groups of patients’ clinical symptoms after operation were significantly improved compared with those before the operation.During the follow-up there were no complications such as internal fixation loosening and fracture in the two groups.There were 2 patients in the observation group who underwent surgery again,and 11 patients in the control group underwent surgery again.The observation group was smaller than the control group,and the two group difference was statistically significant(P<0.05).The VAS score,ODI score,and JOA score of the two groups of patients were significantly improved at all time points after the operation(P<0.05).The VAS score,ODI score and JOA score of the two groups of patients at each time point before and after the operation.The difference between the two groups was not statistically significant(P>0.05).There was no statistically significant difference in the DSH,IVA and ROM groups before the degenerative segment between the two groups(P>0.05).The DSH and IVA observation groups at various time points after the operation were greater than the control group,and the differences between two groups were statistically significant(P<0.05).The ROM observation group at each time point after operation was smaller than the control group.The difference between two groups were statistically significant(P<0.05).Conclusion:The Waveflex dynamic fixation system has achieved satisfactory mid- and long-term effect on the treatment of lumbar degenerative diseases,which can significantly delay the degeneration of adjacent segments and reduce the reoperation rate.

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更新日期/Last Update: 2021-03-15