CAJ | 학술논문

背景：Topping-off技术将坚固的融合和棘突间动态装置组合固定治疗，防止或减缓邻近腰椎节段的退变。 　　目的：观察腰后路椎间融合联合Coflex动态固定(Topping-off技术)对退变椎间盘的保护作用。 　　方法：应用Topping-off技术治疗的32例腰椎退变性疾病患者。随访观察Oswestry功能障碍指数、日本骨科协会评估治疗分数(JOA)、Coflex植入节段活动度， MRI图像中Coflex植入节段椎间盘髓核相对信号强度。结果与结论：所有患者获得12个月以上随访。末次随访时，Oswestry功能障碍指数及日本骨科协会评估治疗分数(JOA)评分，均较治疗前明显改善(P<0.001)；Coflex植入节段的活动度与治疗前比较，差异无显著性意义(P=0.19)；Coflex植入节段相对信号强度较治疗前明显改善(P <0.01)。说明Topping-off技术对椎间盘中短期内有一定的保护作用。
배경：Topping-off기술장견고적융합화극돌간동태장치조합고정치료，방지혹감완린근요추절단적퇴변。 　　목적：관찰요후로추간융합연합Coflex동태고정(Topping-off기술)대퇴변추간반적보호작용。 　　방법：응용Topping-off기술치료적32례요추퇴변성질병환자。수방관찰Oswestry공능장애지수、일본골과협회평고치료분수(JOA)、Coflex식입절단활동도， MRI도상중Coflex식입절단추간반수핵상대신호강도。결과여결론：소유환자획득12개월이상수방。말차수방시，Oswestry공능장애지수급일본골과협회평고치료분수(JOA)평분，균교치료전명현개선(P<0.001)；Coflex식입절단적활동도여치료전비교，차이무현저성의의(P=0.19)；Coflex식입절단상대신호강도교치료전명현개선(P <0.01)。설명Topping-off기술대추간반중단기내유일정적보호작용。
BACKGROUND:Topping-off technique can be used for fixation treatment through the combination of fusion and interspinous dynamic device, in order to prevent or slow down the adjacent lumbar segment degeneration. OBJECTIVE:To obverse the protective effect of Topping-off technique (posterior lumbar interbody fusion procedure combined with the fixation of dynamic interspinous device Coflex) for the degenerative intervertebral disc. METHODS:A total of 32 patients with degenerative lumbar diseases who had been treated with Topping-off technique were included in this study. The Oswestry disability index, the Japanese Orthopaedic Association scores, range of motion for Coflex implanted segment and during the relative signal intensity of the Coflex implanted segment in MRI image were recorded and calculated preoperatively and the entire fol ow-up period. RESULTS AND CONCLUSION:Al patients were fol owed-up for 20.6 months averagely. Up to the last fol ow-up, the Oswestry disability index and Japanese Orthopaedic Association scores were significantly improved when compared with those before treatment (P<0.001). There was no significant difference in the range of motion for Coflex implanted segment before and after treatment (P=0.19). The relative signal intensity of the Coflex implanted segment was significantly improved when compared with that before treatment (P<0.01). The clinical application of the Topping-off technique showed a protective effect on the intervertebral disc.