CAJ | 학술논문

目的：探讨比较 K-Rod 椎弓根动态稳定系统与 Dynesys 非融合系统在多节段腰椎退变的近期临床疗效。方法选择2010年1月至2012年10月于沈阳军区总医院行腰椎手术的60例患者，将其分为 K-Rod 组和 Dynesys 组，各30例。K-Rod 组患者行 K-Rod 椎弓根动态稳定系统内固定术，采用责任节段减压椎间融合内固定术、辅助退变节段非融合内固定术；Dynesys 组患者采用后路减压、椎间探查、Dynesys 非融合内固定术。比较两组患者手术前后 Oswestry 功能评分、目测类比评分、术后腰椎动力位 X 线片、腰椎 ROM 值（腰椎屈伸活动度）、手术时间、术中失血量、术后平均住院时间，评估两种术式近期临床疗效。结果两组患者获得12～24个月随访，K-Rod组和 Dynesys 组术后12个月 Oswestry 功能评分、目测类比评分较术前差异均有统计学意义，但两组间术后12个月 Oswestry 功能评分、目测类比评分、平均手术时间、平均失血量、术后平均住院时间比较差异均无统计学意义。结论 K-Rod 椎弓根动态稳定系统与 Dynesys 非融合系统在治疗多节段腰椎退行性疾病可取得满意的近期临床效果，两者均具有术中失血少、手术时间短、术后对腰椎活动度影响小等优点。
목적：탐토비교 K-Rod 추궁근동태은정계통여 Dynesys 비융합계통재다절단요추퇴변적근기림상료효。방법선택2010년1월지2012년10월우침양군구총의원행요추수술적60례환자，장기분위 K-Rod 조화 Dynesys 조，각30례。K-Rod 조환자행 K-Rod 추궁근동태은정계통내고정술，채용책임절단감압추간융합내고정술、보조퇴변절단비융합내고정술；Dynesys 조환자채용후로감압、추간탐사、Dynesys 비융합내고정술。비교량조환자수술전후 Oswestry 공능평분、목측류비평분、술후요추동력위 X 선편、요추 ROM 치（요추굴신활동도）、수술시간、술중실혈량、술후평균주원시간，평고량충술식근기림상료효。결과량조환자획득12～24개월수방，K-Rod조화 Dynesys 조술후12개월 Oswestry 공능평분、목측류비평분교술전차이균유통계학의의，단량조간술후12개월 Oswestry 공능평분、목측류비평분、평균수술시간、평균실혈량、술후평균주원시간비교차이균무통계학의의。결론 K-Rod 추궁근동태은정계통여 Dynesys 비융합계통재치료다절단요추퇴행성질병가취득만의적근기림상효과，량자균구유술중실혈소、수술시간단、술후대요추활동도영향소등우점。
Objective To compare the short-term clinical effect of K-Rod pedicle dynamic fixation system and Dynesys system for multiple segmental lumbar degeneration. Methods From January 2010 to October 2012,60 patients with multiple segmental lumbar degeneration who were accepted K -Rod pedicle dynamic fixation system and Dynesys system were retrospectively reviewed.The 60 patients were divided into K - Rod group and fusion group,30 cases of patients with K - Rod pedicle dynamic fixation system who were accepted responsibility segmental decompression intervertebral fusion and internal fixation,degenerative segmental unfusion internal fixation.30 cases with Dynesys system who were accepted posterior decompression,discectomy and Dynesys unfusion internal fixation.Clinical assessments were based on comparion of Oswestry disability index score,visual analogous scale (VAS),postoperative lumbar hyperextension,hyperbend X-ray film lumbar ROM value (lumbar flexion mobility),average operation time, intraoperative blood loss,the average length of stay of two groups. Results All of 60 cases were achieved 12 to 24 months follow-up,compared to preoperative,the difference of Oswestry disability index score and visual analogous scale (VAS) for two groups were statistically significant,but the difference of Oswestry disability index score and visual analogous scale (VAS),average operation time,blood loss, the average length of stay(ALOS) between two groups were unstatistically significant. Conclusion In the treatment of multiple segmental lumbar degeneration,both K - Rod pedicle dynamic fixation system and Dynesys system can obtain satisfactory short-term clinical effect and have advantages of less intraoperative blood loss,shorter operation time,postoperative small effects on lumbar spine mobility.