棘突间动态稳定系统治疗腰椎退行性疾病初期效果分析.docVIP

In-Space经皮棘突间系统治疗腰椎初期效果分析【摘要】? ［目的］探讨棘突间系统治疗腰椎的初期效果［方法］治疗腰椎，采用VAS随访有无系统相关并发症及疗效。［结果］棘突间系统手术操作简便，术周及末次随访VAS评分［结论］棘突间系统治疗腰椎退行性疾病简便安全，初期随访疗效良好，为腰椎退行性疾病的治疗增加了新的治疗选择。 【关键词】? 腰椎　　棘突间系统 　　Preliminary evaluation of in lumbar degenerative disease 　　, Zhou Dong, Xu Nanwei. 　　Department of Orthopaedics, Hospital, JiangShu province, China Abstract: ［Objective］To evaluate the early effect of in lumbar degenerative disease. ［Methods］The clinical outcomes of patients with lumbar degenerative disease treated by Interspinous spacer implant or combined with posterior lumbar fusion were retrospectively studied, and assessed with visual analogue scale(VAS) and Oswestry disability index(ODI).The interspinous distance, disc space height, foraminal width and height and segmental lordosis were all tested pre-operation and post-operation. The early effect and complications associated with Interspinous spacer were recorded.［Results］The operative procedure of implant was easy and less invasive. The VAS scores and ODI were better post-operation than pre-operation. The interspinous distance, disc space height, foraminal width and height and segmental lordosis were changed significantly.［Conclusion］It is easy and safe to use in treatment of degenerative lumbar disease, and the early effect is good. The In-space system provides an alternative for treatment of lumbar degenerative disease. ???　 Key? words：lumbar degenerative disease;? ；? interspinous dynamic stabilization??? 　　腰椎不稳是骨科的常见病、多发病，以慢性腰腿痛为主要表现，是引起下腰疼最常见的原因，早期退变期以动力性不稳为主。脊柱融合术是目前治疗腰椎的常规方法。然而，融合固定使相应脊柱节段运动功能丧失，导致邻近节段应力负荷集中、异常活动增加，从而加速了邻近节段的退变。接近脊柱正常生理环境的方法来解决脊柱退行性疾病的问题，非融合动态固定的理念和方法应运而生［］，棘突间稳定系统随着近年临床应用增，初步报道效果令人［］。棘突间系统治疗和预防腰椎退变失稳取得［］自治疗腰椎疾病现将初步结果报告如下。　??? 1? 材料和方法 ?　?? 1.1? 一般资料 ?腰椎疾病患者，男1例、女1例年龄2～8岁，平均岁。腰L4/5 22个节段。所有患者均经持续3个月以上正规保守治疗无效，无重度骨质疏松、无心理精神障碍、身体状况无手术禁忌。 　???1.2? 手术方法 俯卧位，入路　　1.3? 疗效评估 术前、术后疼痛评估采用VAS（visual analogue scale）疼痛10分法；术后功能1.4? 影像学评估 术前、术后周，3、6、12、18个月拍摄腰椎正、侧及屈、伸动力位片，椎高度系统有无。1.5? 统计学分析? 术前术后疼痛VAS评分采用均±标准差，通