保留棘突韧带复合体治疗腰椎退变性疾病的临床效果.docVIP

保留棘突韧带复合体治疗腰椎退变性疾病的临床效果 　　[摘要]目的 探讨保留棘突韧带复合体治疗腰椎退变性疾病的临床效果。方法 回顾性分析2010年6月～2014年12月采取保留棘突韧带复合体治疗腰椎退变性病变的26例患者的临床资料，记录术前与末次随访的VAS、JOA以及ODI评分；分析融合邻近节段UCLA分型的进展情况。结果 随访6～36个月，VAS评分术前为（8.00±0.75）分，末次随访为（1.10±1.05）分，差异有统计学意义（P0.001）；JOA评分术前为（7.45±5.73）分，末次随访为（23.10±3.05）分，差异有统计学意义（P0.001）；ODI评分术前为（30.10±10.40）分，末次随访为（5.10±3.20）分，差异有统计学意义（P0.001）。临床结果以Mac-Nab标准评定，优22例，良2例，可2例，优良率为92.3%。26例患者中，24例融合邻近节段UCLA分型无进展，1例患者由术前B级进展为C级，1例患者由术前C级进展为D级，无一例需要手术治疗。结论 保留棘突韧带复合体治疗腰椎退变性疾病在有效减压、松解神经根、融合手术节段的同时，可有效保护腰椎的稳定性，减少邻近节段退变（ASD），临床疗效满意。 　　[关键词]腰椎；退变性疾病；棘突韧带复合体；椎弓根钉；腰椎融合术；内固定；邻近节段退变；手术效果 　　[中图分类号] R681.55 [文献标识码] A [文章编号] 1674-4721（2018）2（a）-0093-04 　　[Abstract]Objective To investigate the clinical efficacy of reserving spinous process ligament complex in the treatment of lumbar degenerative diseases.Methods From June 2010 to December 2014，26 cases clinical data of spinous process ligament complex treatment of lumbar degenerative disease was analyzed retrospectively，VAS，JOA and ODI scores were recorded Pre-operatively and at last follow-up.The progress of adjacent segment UCLA classification was analyzed. Results After follow-uped for 6-36 months，VAS score was imporved from （8.00±0.75） to （1.10±1.05） at the last follow-up，the difference was statistically significant （P0.001）； JOA score was improved from （7.45±5.73） points to （23.10±3.05） points at the last follow-up，the difference was statistically significant （P0.001）.ODI score was imporved from （30.10±10.40） points to （5.10±3.20） points at the last follow-up，the difference was statistically significant （P0.001）.The clinical results were evaluated by Mac-Nab criteria.The results were excellent in 22 cases，good in 2 cases and fair in 2 cases，with an excellent and good rate of 92.3%.According to UCLA，24 cases without progression，1 case progressed from level B to C，1 case progressed from C to D，there was no need for further surgery.Conclusion Reserving spinous process ligament complex in treatment of lumbar degenerative disease ca