中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2013年
22期
4123-4129
,共7页
丁立祥%陈迎春%张亘瑷%姚琦%侯宇
丁立祥%陳迎春%張亙璦%姚琦%侯宇
정립상%진영춘%장긍애%요기%후우
骨关节植入物%骨与关节学术探讨%后路动态稳定系统%非融合%腰椎间盘突出症%腰椎退行性变%植入物%椎管狭窄%滑脱%疼痛%脊柱融合%椎弓根螺钉%相邻节段退变%生物力学
骨關節植入物%骨與關節學術探討%後路動態穩定繫統%非融閤%腰椎間盤突齣癥%腰椎退行性變%植入物%椎管狹窄%滑脫%疼痛%脊柱融閤%椎弓根螺釘%相鄰節段退變%生物力學
골관절식입물%골여관절학술탐토%후로동태은정계통%비융합%요추간반돌출증%요추퇴행성변%식입물%추관협착%활탈%동통%척주융합%추궁근라정%상린절단퇴변%생물역학
背景:后路动态稳定系统可以用来保留椎体运动节段,减少椎体相邻节段的退变.目的:探讨后路动态稳定系统对腰椎间盘突出症治疗的中期疗效和稳定性.方法:选取首都医科大学附属北京世纪坛医院骨科2009年2月至2011年6月的18例退行性腰椎疾病患者在后路减压的同时行后路动态稳定系统内固定.男11例,女7例;年龄32-67岁,平均年龄45岁.应用目测类比评分进行疼痛评估,以Oswestry功能障碍指数进行临床疗效评价,应用过屈过伸位X射线测量后路动态稳定系统内固定后腰椎间盘和相邻间盘活动度.结果与结论:所有患者随访时间20-45个月,平均随访38个月.目测类比评分后路动态稳定系统内固定治疗前7.1-9.4分,平均得分8.3分,内固定治疗后0-3.1分,平均得分1.5分,目测类比评分改善率为81.5%.Oswestry功能障碍指数在后路动态稳定系统内固定治疗前35-81分(平均60分),内固定治疗后0-45分(平均22分),功能障碍恢复率为63.3%.后路动态稳定系统内固定治疗后1例出现松动,1例出现下肢神经症状一过性加重,3个月后逐渐缓解.腰椎间盘在内固定后平均活动度为5.3°.后路动态稳定系统治疗腰椎间盘突出症可以保留固定节段的活动度和稳定性,中期临床症状恢复良好,说明该系统是治疗腰椎间盘突出症的一种可供选择的非融合性固定方法,但其对相邻节段的影响尚需要进行长期随访.
揹景:後路動態穩定繫統可以用來保留椎體運動節段,減少椎體相鄰節段的退變.目的:探討後路動態穩定繫統對腰椎間盤突齣癥治療的中期療效和穩定性.方法:選取首都醫科大學附屬北京世紀罈醫院骨科2009年2月至2011年6月的18例退行性腰椎疾病患者在後路減壓的同時行後路動態穩定繫統內固定.男11例,女7例;年齡32-67歲,平均年齡45歲.應用目測類比評分進行疼痛評估,以Oswestry功能障礙指數進行臨床療效評價,應用過屈過伸位X射線測量後路動態穩定繫統內固定後腰椎間盤和相鄰間盤活動度.結果與結論:所有患者隨訪時間20-45箇月,平均隨訪38箇月.目測類比評分後路動態穩定繫統內固定治療前7.1-9.4分,平均得分8.3分,內固定治療後0-3.1分,平均得分1.5分,目測類比評分改善率為81.5%.Oswestry功能障礙指數在後路動態穩定繫統內固定治療前35-81分(平均60分),內固定治療後0-45分(平均22分),功能障礙恢複率為63.3%.後路動態穩定繫統內固定治療後1例齣現鬆動,1例齣現下肢神經癥狀一過性加重,3箇月後逐漸緩解.腰椎間盤在內固定後平均活動度為5.3°.後路動態穩定繫統治療腰椎間盤突齣癥可以保留固定節段的活動度和穩定性,中期臨床癥狀恢複良好,說明該繫統是治療腰椎間盤突齣癥的一種可供選擇的非融閤性固定方法,但其對相鄰節段的影響尚需要進行長期隨訪.
배경:후로동태은정계통가이용래보류추체운동절단,감소추체상린절단적퇴변.목적:탐토후로동태은정계통대요추간반돌출증치료적중기료효화은정성.방법:선취수도의과대학부속북경세기단의원골과2009년2월지2011년6월적18례퇴행성요추질병환자재후로감압적동시행후로동태은정계통내고정.남11례,녀7례;년령32-67세,평균년령45세.응용목측류비평분진행동통평고,이Oswestry공능장애지수진행림상료효평개,응용과굴과신위X사선측량후로동태은정계통내고정후요추간반화상린간반활동도.결과여결론:소유환자수방시간20-45개월,평균수방38개월.목측류비평분후로동태은정계통내고정치료전7.1-9.4분,평균득분8.3분,내고정치료후0-3.1분,평균득분1.5분,목측류비평분개선솔위81.5%.Oswestry공능장애지수재후로동태은정계통내고정치료전35-81분(평균60분),내고정치료후0-45분(평균22분),공능장애회복솔위63.3%.후로동태은정계통내고정치료후1례출현송동,1례출현하지신경증상일과성가중,3개월후축점완해.요추간반재내고정후평균활동도위5.3°.후로동태은정계통치료요추간반돌출증가이보류고정절단적활동도화은정성,중기림상증상회복량호,설명해계통시치료요추간반돌출증적일충가공선택적비융합성고정방법,단기대상린절단적영향상수요진행장기수방.
@@@@BACKGROUND: Posterior dynamic stabilization system can be used to maintain the vertebral motion segment and reduce the degeneration of vertebral body adjacent segment. OBJECTIVE: To investigate the efficacy and stability of posterior dynamic stabilization system for the treatment of lumbar disc herniation. METHODS: Eighteen patients with degenerative lumbar disease and treated with posterior decompression and posterior dynamic stabilization system internal fixation in the Department of Orthopedics, Beijing Shijitan Hospital Affiliated to Capital Medical University from February 2009 to June 2011 were selected, included 11 male patients and seven female patients, the age was 32-67 years old and averaged in 45 years old. The visual analogue scale score was used for pain assessment and the Oswestry disability index was used for clinical evaluation, the flexion and hyperextension X-ray films were used to measure the activity of lumbar intervertebral disc and the adjacent intervertebral disc after posterior dynamic stabilization system fixation. RESULTS AND CONCLUSION: Al the patients were fol owed-up for 20-45 months, averaged in 38 months. The visual analogue scale score before posterior dynamic stabilization system fixation was 7.1-9.4 points, and averaged 8.3 points, the postoperative score was 0-3.1 points, averaged 1.5 points, the improvement rate of visual analogue scale score was 81.5%. The Oswestry disability index before posterior dynamic stabilization system fixation was 35-81 points (average 60 points) and 0-45 points after fixation (average 22 points), and the improvement rate of Oswestry disability index was 63.3%. There was one case of loosening after posterior dynamic stabilization system fixation, one case had lower extremity nerve symptoms transient increasing and relieved after 3 months. The average range of motion after fixation was 5.3°. The posterior dynamic stabilization system for the treatment of lumbar disc herniation can maintain the range of motion and stability of the fixed segment with wel recovered medium-term clinical symptoms, suggesting that this system is an alternative non-fusion fixation method for the treatment of lumbar disc herniation, but the effect on the adjacent segment stil need to be identified with long-term fol ow-up.
