CAJ | 학술논문

目的：对比 Bioflex 动态内固定术与经后路椎体间融合术（PLIF）治疗单节段腰椎退变性疾病的中期临床疗效．方法：收集我院行 Bioflex 动态内固定术（Bioflex 组）治疗单节段腰椎退变性疾病28例，经后路椎体间融合术（PLIF 组）37例，比较 Bioflex 组与 PLIF 组手术时间、术中出血量、术后引流量等临床资料；术前及术后末次随访的 Oswestry 功能障碍指数（ODI）、视觉模拟评分法（VAS）手术节段及其上邻节段活动度（Range of motion，ROM），评估两组临床疗效．结果：随访24～48个月，平均36．8个月，Bioflex 组手术时间、术中出血量、术后引流量较 PLIF 组少（P ＜0.05）．末次随访时：两组 VAS 评分、ODI 评分均较术前有明显改善（P ＜0.05）；两组手术节段 ROM较术前减小（P ＜0.05），Bioflex 组手术节段 ROM较 PLIF 组大（P ＜0.05）；两组术后上邻近节段 ROM较术前增大（P ＜0.05），Bioflex 组术后上邻近节段 ROM比 PLIF 组小（P ＜0.05）．结论：Bioflex 动态内固定术治疗单节段腰椎退变性疾病的中期临床疗效满意．与传统术式 PLIF 比较，Bioflex 动态固定能够部分保留手术节段 ROM，不增加上邻节段 ROM，同时具有手术时间短、术中出血少、术后引流少的优势．
목적：대비 Bioflex 동태내고정술여경후로추체간융합술（PLIF）치료단절단요추퇴변성질병적중기림상료효．방법：수집아원행 Bioflex 동태내고정술（Bioflex 조）치료단절단요추퇴변성질병28례，경후로추체간융합술（PLIF 조）37례，비교 Bioflex 조여 PLIF 조수술시간、술중출혈량、술후인류량등림상자료；술전급술후말차수방적 Oswestry 공능장애지수（ODI）、시각모의평분법（VAS）수술절단급기상린절단활동도（Range of motion，ROM），평고량조림상료효．결과：수방24～48개월，평균36．8개월，Bioflex 조수술시간、술중출혈량、술후인류량교 PLIF 조소（P ＜0.05）．말차수방시：량조 VAS 평분、ODI 평분균교술전유명현개선（P ＜0.05）；량조수술절단 ROM교술전감소（P ＜0.05），Bioflex 조수술절단 ROM교 PLIF 조대（P ＜0.05）；량조술후상린근절단 ROM교술전증대（P ＜0.05），Bioflex 조술후상린근절단 ROM비 PLIF 조소（P ＜0.05）．결론：Bioflex 동태내고정술치료단절단요추퇴변성질병적중기림상료효만의．여전통술식 PLIF 비교，Bioflex 동태고정능구부분보류수술절단 ROM，불증가상린절단 ROM，동시구유수술시간단、술중출혈소、술후인류소적우세．
Aim:To study the therapeutic effect of the Bioflex dynamic fixation in treatment of segmen-tal lumbar degenerative disease.Methods:Total of 65 consecutive patients with degenerative lumbar dis-ease met the strict inclusion and exclusion criteria,28 patients were treated with Bioflex dynamic fixation group,37patients underwent rigid fixation and fusion PLIF,The clinical efficacy was evaluated by observ-ing clinical data such as VAS score,ODI score,operativing time,blood loss,and imaging features such as the intervertebral range of motion.Results:All patients follow-up for 24 to 48 months (mean 36.8 months),The operating time,blood loss,postoperative drainage in the Bioflex were significant lower than those in the group of PLIF group(P <0.05).VAS、ODI of the final follow-up were significant lower than that of pre-operation in both groups(P <0.05 );Two groups of instrumented segments ROM operation showed significant less(P <0.05),the instrumented segmental ROM of Bioflex group were higher than the PLIF group(P <0.05);But the adjacent segment ROMof PLIF Group was higher than before opera-tion(P <0.05);the adjacent segment of Bioflex group was lower than group PLIF(P <0.05).Conclu-sion:Bioflex dynamic fixation is satisfactory in treatment of lumbar degenerative disease.Compared with the traditionnal PLIF,Bioflex dynamic fixation can preserves functional motion to some degree,also pre-vent adjacent segment ROMfrom increasing,at the same time,it has the many advantages,such as shor-ter operating time,less bleeding and postoperative drainage.