中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2015年
31期
5036-5040
,共5页
植入物%脊柱植入物%腰椎融合%退变性腰椎滑脱%核心稳定性训练%Oswestry功能障碍指数%躯干肌肌力训练
植入物%脊柱植入物%腰椎融閤%退變性腰椎滑脫%覈心穩定性訓練%Oswestry功能障礙指數%軀榦肌肌力訓練
식입물%척주식입물%요추융합%퇴변성요추활탈%핵심은정성훈련%Oswestry공능장애지수%구간기기력훈련
Lumbar Vertebrae%Degenerative Disease%Internal Fixators%Functional Training
背景：腰椎退变性疾病是脊柱外科中的常见病、多发病，并且随着年龄的增加，发病率升高。目的：通过对腰椎退变性疾病不同分期植入物内固定腰椎融合治疗及功能训练后脊柱稳定性分析，为提高临床治疗效果改善患者生活质量提供指导。方法：①采用前瞻性随机对照设计，将52例Ⅰ度、Ⅱ度退变性腰椎滑脱患者随机分为训练组和对照组，每组26例。对照组给予传统训练，训练组给予核心稳定性训练，疗程24周。分别在治疗后6，12，24周进行数字疼痛评分和Oswestry功能障碍指数疗效评定。②通过数据库文献检索方法评估腰椎融合及植入物内固定修复退变性腰椎滑脱后的脊柱稳定性。结果与结论：①治疗24周后，训练组的数字疼痛评分和Oswestry功能障碍指数均明显低于对照组(P <0.05或P <0.01)。核心稳定性训练对腰椎滑脱患者疼痛的缓解和恢复机体活动能力有显著效果。核心稳定性训练对退变性腰椎滑脱所致的慢性腰痛及功能改善优于传统的功能训练。②椎弓根固定并后外侧融合与后侧椎体间融合都可有效治疗Ⅱ度以内腰椎滑脱，后侧椎体间融合能更好的维持滑脱矫形及结构的稳定，后外侧融合后期易出现矫正丢失及内固定失败等问题，但临床疗效不受明显影响。
揹景：腰椎退變性疾病是脊柱外科中的常見病、多髮病，併且隨著年齡的增加，髮病率升高。目的：通過對腰椎退變性疾病不同分期植入物內固定腰椎融閤治療及功能訓練後脊柱穩定性分析，為提高臨床治療效果改善患者生活質量提供指導。方法：①採用前瞻性隨機對照設計，將52例Ⅰ度、Ⅱ度退變性腰椎滑脫患者隨機分為訓練組和對照組，每組26例。對照組給予傳統訓練，訓練組給予覈心穩定性訓練，療程24週。分彆在治療後6，12，24週進行數字疼痛評分和Oswestry功能障礙指數療效評定。②通過數據庫文獻檢索方法評估腰椎融閤及植入物內固定脩複退變性腰椎滑脫後的脊柱穩定性。結果與結論：①治療24週後，訓練組的數字疼痛評分和Oswestry功能障礙指數均明顯低于對照組(P <0.05或P <0.01)。覈心穩定性訓練對腰椎滑脫患者疼痛的緩解和恢複機體活動能力有顯著效果。覈心穩定性訓練對退變性腰椎滑脫所緻的慢性腰痛及功能改善優于傳統的功能訓練。②椎弓根固定併後外側融閤與後側椎體間融閤都可有效治療Ⅱ度以內腰椎滑脫，後側椎體間融閤能更好的維持滑脫矯形及結構的穩定，後外側融閤後期易齣現矯正丟失及內固定失敗等問題，但臨床療效不受明顯影響。
배경：요추퇴변성질병시척주외과중적상견병、다발병，병차수착년령적증가，발병솔승고。목적：통과대요추퇴변성질병불동분기식입물내고정요추융합치료급공능훈련후척주은정성분석，위제고림상치료효과개선환자생활질량제공지도。방법：①채용전첨성수궤대조설계，장52례Ⅰ도、Ⅱ도퇴변성요추활탈환자수궤분위훈련조화대조조，매조26례。대조조급여전통훈련，훈련조급여핵심은정성훈련，료정24주。분별재치료후6，12，24주진행수자동통평분화Oswestry공능장애지수료효평정。②통과수거고문헌검색방법평고요추융합급식입물내고정수복퇴변성요추활탈후적척주은정성。결과여결론：①치료24주후，훈련조적수자동통평분화Oswestry공능장애지수균명현저우대조조(P <0.05혹P <0.01)。핵심은정성훈련대요추활탈환자동통적완해화회복궤체활동능력유현저효과。핵심은정성훈련대퇴변성요추활탈소치적만성요통급공능개선우우전통적공능훈련。②추궁근고정병후외측융합여후측추체간융합도가유효치료Ⅱ도이내요추활탈，후측추체간융합능경호적유지활탈교형급결구적은정，후외측융합후기역출현교정주실급내고정실패등문제，단림상료효불수명현영향。
BACKGROUND:Lumbar degenerative disease is a common and frequently occurring disease in spinal surgery. With increasing age, the incidence rate is increased. OBJECTIVE: To elevate clinical outcomes and improve the quality of life of patients by analyzing spinal stability after lumbar implant fixation fusion and functional training in treatment of lumbar degenerative disease. METHODS: (1) We used a prospective randomized controled design. The 52 patients with I° or II° degenerative lumbar spondylolisthesis were randomly divided into two groups, with 26 cases in each group. Conventional exercises were carried out in the control group and core stabilization exercises for the treatment group, with course of treatment for 24 weeks. Curative effects of numerical rating scale and the Oswestry Disability Index were compared at 6, 12 and 24 weeks after treatment respectively. (2) Spinal stability after lumbar fusion and fixation of the implant for degenerative lumbar spondylolisthesis was evaluated by database document retrieval. RESULTS AND CONCLUSION:(1) After 24 weeks, numerical rating scale score and the Oswestry Disability Index were significantly lower in the treatment group than in the control group (P < 0.05 orP < 0.01). Core stabilization exercises apparently relieve lumbar pain and improve the ability of activities. Core stabilization exercises are better than conventional training. (2) Pedicle instrument fixation combined with interbody fusion is effective for lumbar spondylolisthesis within the second degree. Posterior interbody fusion has predominant mechanical property in maintaining spondylolisthesis orthopedic and stabilizing the structure. Correction loss and fixation failure easily occur after posterolateral fusion, but clinical effects are not affected.
