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
39期
6327-6332
,共6页
骨科植入物%脊柱植入物%坚强内固定技术%半限制%非融合%腰椎退行性疾病%中期临床效果
骨科植入物%脊柱植入物%堅彊內固定技術%半限製%非融閤%腰椎退行性疾病%中期臨床效果
골과식입물%척주식입물%견강내고정기술%반한제%비융합%요추퇴행성질병%중기림상효과
Internal Fixators%Lumbar Vertebrae%Spinal Fusion
背景：相比于坚强内固定，Cosmic半限制非融合系统可于术中减少对腰椎生理结构的破坏，保留手术节段部分活动度，维持节段稳定性，有助于预防毗邻节段退变。<br> 目的：观察Cosmic半限制非融合系统治疗腰椎退行性疾病的中期随访结果。<br> 方法：纳入腰椎退行性疾病患者21例，其中男10例，女11例，年龄19-63岁，均采用后路开窗减压，清除髓核，在手术节段置入Cosmic半限制非融合系统，评估治疗前后的目测类比评分、Oswestry 功能障碍指数，以及手术节段、毗邻上节段的椎间隙高度与活动范围。<br> 结果与结论：所有患者治疗后接受随访15-48个月，未发生内固定松动、断裂与脱落，末次随访的目测类比评分、Oswestry功能障碍指数均低于治疗前(P <0.01)。末次随访时，手术节段及毗邻上节段的椎间隙高度与治疗前比较差异均无显著性意义，手术节段的活动度低于治疗前(P<0.01)，毗邻上节段的活动度与治疗前比较差异无显著性意义。表明 Cosmic 半限制非融合系统可于术中减少对腰椎生理结构的破坏，保留手术节段部分活动度，维持节段稳定性，有助于预防毗邻节段退变，中期疗效较好。
揹景：相比于堅彊內固定，Cosmic半限製非融閤繫統可于術中減少對腰椎生理結構的破壞，保留手術節段部分活動度，維持節段穩定性，有助于預防毗鄰節段退變。<br> 目的：觀察Cosmic半限製非融閤繫統治療腰椎退行性疾病的中期隨訪結果。<br> 方法：納入腰椎退行性疾病患者21例，其中男10例，女11例，年齡19-63歲，均採用後路開窗減壓，清除髓覈，在手術節段置入Cosmic半限製非融閤繫統，評估治療前後的目測類比評分、Oswestry 功能障礙指數，以及手術節段、毗鄰上節段的椎間隙高度與活動範圍。<br> 結果與結論：所有患者治療後接受隨訪15-48箇月，未髮生內固定鬆動、斷裂與脫落，末次隨訪的目測類比評分、Oswestry功能障礙指數均低于治療前(P <0.01)。末次隨訪時，手術節段及毗鄰上節段的椎間隙高度與治療前比較差異均無顯著性意義，手術節段的活動度低于治療前(P<0.01)，毗鄰上節段的活動度與治療前比較差異無顯著性意義。錶明 Cosmic 半限製非融閤繫統可于術中減少對腰椎生理結構的破壞，保留手術節段部分活動度，維持節段穩定性，有助于預防毗鄰節段退變，中期療效較好。
배경：상비우견강내고정，Cosmic반한제비융합계통가우술중감소대요추생리결구적파배，보류수술절단부분활동도，유지절단은정성，유조우예방비린절단퇴변。<br> 목적：관찰Cosmic반한제비융합계통치료요추퇴행성질병적중기수방결과。<br> 방법：납입요추퇴행성질병환자21례，기중남10례，녀11례，년령19-63세，균채용후로개창감압，청제수핵，재수술절단치입Cosmic반한제비융합계통，평고치료전후적목측류비평분、Oswestry 공능장애지수，이급수술절단、비린상절단적추간극고도여활동범위。<br> 결과여결론：소유환자치료후접수수방15-48개월，미발생내고정송동、단렬여탈락，말차수방적목측류비평분、Oswestry공능장애지수균저우치료전(P <0.01)。말차수방시，수술절단급비린상절단적추간극고도여치료전비교차이균무현저성의의，수술절단적활동도저우치료전(P<0.01)，비린상절단적활동도여치료전비교차이무현저성의의。표명 Cosmic 반한제비융합계통가우술중감소대요추생리결구적파배，보류수술절단부분활동도，유지절단은정성，유조우예방비린절단퇴변，중기료효교호。
BACKGROUND:Compared with rigid internal fixation, semi-restricted non-fusion system (Cosmic) can reduce the destruction of lumbar physiological structure during operation, partly retain the range of motion, maintain the stability of surgical segment, and help to prevent the adjacent segment degeneration. <br> OBJECTIVE:To observe the mid-term folow-up outcome of semi-restricted non-fusion system (Cosmic) in the treatment of lumbar degenerative disease. <br> METHODS:21 patients with lumbar degenerative disease, including 10 male patients and 11 female patients, at the age of 19-63 years old, received posterior decompression by fenestration, nucleotomy, and Cosmic system internal fixation. Visual analogue scale score and Oswestry disability index were used for clinical evaluation. Intervertebral height and range of motion of surgical segment and the proximal adjacent segment were colected before and after operation. <br> RESULTS AND CONCLUSION: Al the patients were folowed up for 15-48 months. No internal fixator loosening or rupture was found during the folow-up. The visual analogue scale score and Oswestry disability index at the last folow-up were lower than those before operation (P < 0.01). During the last folow-up, there were no significant differences in the intervertebral height of surgical segment and the proximal adjacent segment, and the range of motion of surgical segment was lower than that before operation (P < 0.01). No significant difference was found in range of motion of the proximal adjacent segment. These results suggest that semi-restricted dynamic non-fusion system (Cosmic) can reduce the destruction of lumbar physiological structure during operation, partly retain the range of motion, maintain the stability of surgical segment, and help to prevent the adjacent segment degeneration with wel mid-term folow-up outcomes.
