基于Waveflex系统的Hybrid术式在腰椎退变性疾病中的临床应用观察
摘要
目的探讨基于Waveflex系统的Hybrid术式在腰椎退变性疾病中的临床应用及疗效。方法回顾性分析收治并符合纳入标准的腰椎退变性疾病患者的临床资料。男9例,女11例;年龄63～75岁,中位年龄66.2岁。患者均采用Waveflex内固定系统进行融合与非融合结合的Hybrid术式治疗。采用疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评价患者症状改善情况,Stauffer-Coventry评价标准进行临床疗效评价。测量术前及术后末次随访时手术固定节段近端邻近椎间隙高度(DSH)、活动范围(ROM),评价邻椎间隙退变情况。结果 20例患者随访时间12～42个月,平均24.5个月。术后末次随访时,VAS、ODI评分均较术前明显改善(P<0.05)。末次随访时,根据Stauffer-Coventry评价标准,临床疗效评价优17例,良2例,中1例,差0例,优良率为95%。术后末次随访时邻近节段DSH、ROM与术前比较,差异均无统计学意义(P>0.05)。结论 Waveflex内固定系统联合应用Hybrid术式治疗腰椎退变性疾病临床早期疗效满意,为老年腰椎退行性疾病的手术治疗提供了新的选择,但其长期效果仍需要进一步进行临床对照研究。
引文
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[11] 胡明,马远征,李大伟,等.Waveflex动态稳定系统治疗腰椎退变性疾病的早期临床观察[J].中国骨与关节外科,2013,6(2):113-116.
[2] Park P,Garton HJ,Gala VC,et al.Adjacent segment disease after lumbar or lumbosacral fusion :review of the literature[J].Spine,2004,29(17):1938-1944.
[3] Kumar M,Baklanov A,Chopin D.Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion[J].European Spine Journal,2001,4:314-319.
[4] Schwarzenbach O,Rohrbach N,Berlemann U.Segment-by-segment stabilization for degenerative disc disease:a hybrid technique[J].European Spine Journal,2010,19(6):1010-1020.
[5] Bambakidis NC,Feiz-Erfan I,Klopfenstein JD,et al.Indications for surgical fusion of the cervical and lumbar motion segment[J].Spine,2005,30(Suppl 16):2-6.
[6] Delawi D,Dhert WJ,Castelein RM,et al.The incidence of donor site pain after bone graft harvesting from the posterior iliac crest May be overestimated-A study on spine fracture patients[J].Spine,2007,32(17):1865-1868.
[7] Cheh G,Bridwell KH,Lenke LG,et al.Adjacent segment disease following lumbar/thoracolumbar fusion with pedicle screw instrumentation-A minimum 5-year follow-up[J].Spine,2007,32(20):2253-2257.
[8] Xia Xiaopeng,Chen Honglin,Cheng Hongbin.Prevalence of adjacent segment degeneration after spine surgery:a systematic review and meta-analysis[J].Spine,2013,38(7):597-608.
[9] Resnick DK,Choudhri TF,Dailey AT,et al.Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine[J].J Neurosurg Spine,2005,2(6):658-661.
[10] Bertagnoli R,Yue JJ,Kershaw T,et al.Lumbar total disc arthroplasty utilizing the ProDisc prosthesis in smokers versus nonsmokers-A prospective study with 2-year minimum follow-up[J].Spine,2006,31(9):992-997.
[11] 胡明,马远征,李大伟,等.Waveflex动态稳定系统治疗腰椎退变性疾病的早期临床观察[J].中国骨与关节外科,2013,6(2):113-116.