| 丁国强 李少波 李炎 谢肇 周强.动态中和固定系统与后路锥间融合术治疗退变性椎管狭窄的近期疗效对
比研究[J].,2014,14(31):6151-6155 |
| 动态中和固定系统与后路锥间融合术治疗退变性椎管狭窄的近期疗效对
比研究 |
| Comparative Study on Short TermEfficacy between Dynamic NeutralizationSystemand Posterior Intervertebral Fusion for Degenerative Spinal Stenosis |
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| DOI： |
| 中文关键词: 退行性变 椎管狭窄 动态中和固定系统 后路椎间融合术 活动度 |
| 英文关键词: Degeneraton Spinal stenosis Dynamic neutralization system Posterior interior intervertebral fusion Range of motion |
| 基金项目:四川省教育厅科学技术研究项目（2010652) |
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| 中文摘要: |
| 目的：对比动态中和固定系统（Dynesys）与后路锥间融合术治疗退变性椎管狭窄的近期疗效。方法：70 例椎管狭窄伴或不伴
椎间盘突出患者，随机分为Dynesys 组与后路锥间融合术组。前者行椎板减压并Dynesys内固定，后者行减压术并锥间融合术，术
后随访24 个月，对比两组术后功能恢复情况、椎间隙高度、活动度及邻近节段退变情况。结果：①两组患者术后随访结束时ODI
指数、VAS 评分均较手术前明显下降（P＜0.05），两组0DI指数与VAS 评分无显著性差异（P＞ 0.05）。② 术后两组固定节段间隙均
较手术前明显增加（P＜0.05），Dynesys 组L4-5 节段、L5-S1 节段活动度大为下降（P＜0.05），融合术组相应节段均融合良好，无活
动度。③Dynesys 组头侧相邻节段活动度与术前无明显变化，融合术组头侧相邻节段较术前活动度明显增加（t=2.286，P=0.026），
两组术头侧相邻节段活动组差异有统计学意义（t=3.125，P=0.003）。④ 随访结束时Dynesys组有1 例(2.6 %)患者S1 节段出现1 根
螺钉松动，邻近节段未见退变病例；融合组有4 例(12.5 %)邻近节段出现Ⅰ-Ⅱ度退变，两组邻近节段退变率差异有统计学意义
（fisher p=0.039）。结论：Dynesys动态固定植入手术与传统后路椎间融合术治疗退行性椎管狭窄术后短期内效果相当，前者对邻
近节段活动性的影响小于融合术。 |
| 英文摘要: |
| Objective:To compare short term efficacy between dynamic neutralization system and posterior interior intervertebral
fusion for degenerative spinal stenosis.Methods:70 Patients with intervertebral disc herniation with spinal canal stenosis or not were
randomly divided into dynesys group (n=38) and posterior intervertebral fusion group(n=32), the former group was applied with vertebral
decompression and dynesys internal fixation, and the latter was given decompression and posterior intervertebral fusion, follow-up for 24
months, and postoperative function recovery, intervertebral space height, motion range and degeneration of adjacent segment were
compared between the two groups.Results:① All patients were successfully operated and followed up for 24 months. At the end of
follow-up, ODI and VAS scores of patients in two groups were significantly decreased compared with preoperation (P<0.05), but there
was no significant difference between the ODI score and VAS score (P>0.05). ② The fixed segment spaces of the two groups were
significantly increased compared with preoperation (P<0.05), Range of motion of L4-5 segment and L5-S1 segment of dynesys group was
significantly decreased (P<0.05). However, the fusion segment of Fusion group fixed good and there was no activity. ③Cranial adjacent
segment activity of pre&post treatment had no obvious change in dynesys group, cranial adjacent segment activity of fusion group
increased significantly compared with preoperation (t=2.286, P=0.026),the difference was statistically significant between the two groups
(t=3.125, p=0.003). ④ At the end of follow-up, One case (2.6%) in dynesys group had one screw loosening at S1 segment, no other
adjacent segment was found degeneration; fusion group had four cases (12.5%) hadⅠ -Ⅱ degree adjacent segment degeneration,The
difference was significant between the two groups (P=0.039).Conclusion:The short term effect of dynesys dynamic fixation operation
and traditional posterior interior intervertebral fusion for degenerative spinal whose short-term efficacy postoperativly were similar, but
adverse influence of the former on adjacent segment activity is less than fusion method. |
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