CAJ | 학술논문

目的比较棘突间Coflex动态内固定术(A组)与腰椎椎弓根螺钉加弹性棒内固定术(B组)两种腰椎非融合内固定手术方式治疗腰椎间盘突出症的早期手术疗效.方法对2008年3月至2012年3月经郑州大学第一附属医院确诊为单节段腰椎间盘突出(L4/5)的22例患者行腰椎非融合内固定手术治疗并对其进行短期随访调查研究,术后随访时间为(6.87±3.25)个月.术前术后分别用JOA评分和ODI指数对早期临床疗效进行评价,并比较两种术式的手术时间、出血量.结果术后两组患者JOA评分(A组25.00±2.65、B组24.70±3.04)较术前(A组10.10±4.78、B组10.70±5.21)明显提高(p＜0.05),术后ODI指数(A组3.40±2.74、B组3.30±2.68)较术前(A组25.30±8.82、B组24.80±7.93)明显下降,两种手术方式疗效差异无统计学意义(P＞0.05)；两种手术方式手术时间及出血量差异有统计学意义(P＜0.05).结论两种腰椎非融合内固定术比较,棘突间Coflex动态内固定术相对手术时间短、术中出血量少；两者均能保留一定的腰椎活动度,改善临床症状,获得较满意的疗效,早期疗效差异无统计学意义.
목적 비교극돌간Coflex동태내고정술(A조)여요추추궁근라정가탄성봉내고정술(B조)량충요추비융합내고정수술방식치료요추간반돌출증적조기수술료효.방법 대2008년3월지2012년3월경정주대학제일부속의원학진위단절단요추간반돌출(L4/5)적22례환자행요추비융합내고정수술치료병대기진행단기수방조사연구,술후수방시간위(6.87±3.25)개월.술전술후분별용JOA평분화ODI지수대조기림상료효진행평개,병비교량충술식적수술시간、출혈량.결과 술후량조환자JOA평분(A조25.00±2.65、B조24.70±3.04)교술전(A조10.10±4.78、B조10.70±5.21)명현제고(p＜0.05),술후ODI지수(A조3.40±2.74、B조3.30±2.68)교술전(A조25.30±8.82、B조24.80±7.93)명현하강,량충수술방식료효차이무통계학의의(P＞0.05)；량충수술방식수술시간급출혈량차이유통계학의의(P＜0.05).결론 량충요추비융합내고정술비교,극돌간Coflex동태내고정술상대수술시간단、술중출혈량소；량자균능보류일정적요추활동도,개선림상증상,획득교만의적료효,조기료효차이무통계학의의.
Objective To compare the early curative effectiveness between two non-fusion and internal fixation treatments (lumbar pedicle screws combined with elastic rod fixation treatment vs.interspinous dynamic internal fixation with Coflex treatment) for lumbar intervertebral disc protrusion.Methods From March 2011to March 2012,there were 22 patients diagnosed as having single segmental lumbar intervertebral disc protrusion (L4/5) in the hospital,and subjected to lumbar non-fusion fixation operation.All patients were followed up for 3 to 13 months (mean 6.87 ± 3.25 months).Early clinical efficacy was evaluated before and after operation respectively by the JOA score and ODI index.Operative time and bleeding loss were compared between the two treatments.Results The JOA score in two groups was significantly increased (P ＜ 0.05) after the operation (pre-operation:10.10 ± 4.78,10.70:5.21 ; postoperation:25.00 ± 2.65,24.70 ± 3.04),and ODI index was significantly decreased (pre-operation:25.30 ± 8.82,24.80 ± 7.93 ; postoperation:3.40 ± 2.74,3.30 ± 2.68).There was significant difference in the curative effectiveness between two groups (P ＞ 0.05).Operative time and bleeding loss showed statistically significant difference between two groups (P ＜ 0.05).Conclusion Interspinous dynamic intemal fixation with Coflex treatment has shorter operative time,and less bleeding loss during operation.Both treatments can retain a certain degree of lumbar spine mobility,improve clinical symptoms,and obtain satisfactory curative effectiveness,but there is no significant difference in early curative effectiveness between them.