| Wallis棘突间动态稳定系统对缓解腰椎融合术后邻近节段退变的临床疗效分析 |
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投稿时间：2013-02-16
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| 作者 | Author | 单位 | Address | E-Mail |
| 徐建平 |
XU Jian-ping |
南京军区福州总医院第一附属医院骨科, 福建 莆田 351100 |
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| 易红蕾 |
YI Hong-lei |
第二军医大学附属长海医院脊柱外科, 上海 200433 |
Department of Spinal Surgery, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai 200433, China |
hongleiyi2011@163.com |
| 李明 |
LI Ming |
第二军医大学附属长海医院脊柱外科, 上海 200433 |
Department of Spinal Surgery, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai 200433, China |
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| 石志才 |
SHI Zhi-cai |
第二军医大学附属长海医院脊柱外科, 上海 200433 |
Department of Spinal Surgery, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai 200433, China |
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| 栗景峰 |
LI Jing-feng |
第二军医大学附属长海医院脊柱外科, 上海 200433 |
Department of Spinal Surgery, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai 200433, China |
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| 赵颖川 |
ZHAO Ying-chuan |
第二军医大学附属长海医院脊柱外科, 上海 200433 |
Department of Spinal Surgery, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai 200433, China |
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| 林国兵 |
LIN Guo-bing |
南京军区福州总医院第一附属医院骨科, 福建 莆田 351100 |
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| 王怀云 |
WANG Huai-yun |
南京军区福州总医院第一附属医院骨科, 福建 莆田 351100 |
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| 沈峰 |
SHEN Feng |
南京军区福州总医院第一附属医院骨科, 福建 莆田 351100 |
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| 期刊信息：《中国骨伤》2013年，第26卷，第12期，第1005-1009页 |
| DOI：10.3969/j.issn.1003-0034.2013.12.009 |
| 基金项目: |
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中文摘要:
目的：在行腰椎管减压融合的手术中，置入Wallis棘突间稳定系统，分析其缓解邻近节段腰椎退变的疗效.
方法：自2007年7月至2009年7月，采用腰椎后路减压融合内固定术治疗腰椎退变性疾病患者40例（男16例，女24例，年龄25～60岁），其中20例患者行腰椎后路减压融合内固定术的同时于具有退变趋势的邻近节段置入棘突间稳定系统Wallis固定（试验组），其余20例单纯行腰椎后路减压融合内固定术 （对照组）.分别于置入后1个月、3年对两组患者进行术后的JOA评分和目测类比评分（VAS），同时测量并计算两组患者手术前后邻近节段椎间隙高度和椎管面积的变化情况.
结果：40例患者均获得随访，时间3～5年，平均3.6年.40例患者伤口均Ⅰ类甲级愈合，术后疼痛情况均较术前缓解.两组患者置入后1个月JOA及VAS评分比较差异无统计学意义（P>0.05）;术后3年JOA及VAS评分比较差异有统计学意义（P<0.05）.两组患者术后1个月邻近节段椎间隙高度、椎管面积变化比较差异无统计学意义（P>0.05）;术后3年邻近节段椎间隙高度、椎管面积变化比较差异有统计学意义（P<0.05）.
结论：两种术式即刻效果无差异，均能取得良好的效果，此效果主要依赖于手术有效的减压.试验组中期效果明显优于对照组，主要是棘突间稳定系统Wallis发挥良好的生物学作用，有效减缓了因腰椎融合术导致的邻近节段的加速退变. |
| 【关键词】腰椎 脊柱融合术 外科减压术 |
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| Clinical application of Wallis interspinous dynamic stabilization in treating adjacent segment degeneration(ASD) after lumbar spinal fusion |
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ABSTRACT
Objective: To evaluate therapeutic effects of Wallis interspinous dynamic stabilization in treating ASD after lumbar spinal fusion.
Methods: Totally 40 patients (included 16 males and 24 females,aged 25 to 60 years old) with degenerative disc disease were treated with posterior interbody fusion. Among them,20 cases(treatment group) were treated with posterior interbody fusion combined with Wallis interspinous dynamic stabilization,while other 20 cases (control group) only treated with posterior interbody fusion. JOA score and VAS score were compared after inserted Wallis interspinous dynamic stabilization at 1 month and 3 years,and changes of intervertebral disc height of adjacent segment and cross-sectional area of the canal were tested and compared.
Results: All patients were followed up from 3 to 5 years with an average of 3.6 years. All injuries were healed at stageⅠand the pain were released after treatment. There were no significant meaning in JOA score and VAS score at 1 month after treatment between two groups(P>0.05),while had meaning at 3 years(P<0.05). There were no statistical significane in intervertebral disc height of adjacent segment and cross-sectional area of the canal at 1 month after treatment (P>0.05),while had statistical meaning at 3 years(P<0.05).
Conclusion: There is no difference in immediate effects between two groups. Both of them can obtain good results for effective decompression. Medial-term effectiveness of treatment group is obviously better than control group,which depends on Wallis interspinous dynamic stabilization to plays good biology effects and effective accelerate adjacent degeneration caused by lumbar fusion. |
| KEY WORDS Lumbar vertebrae Spinal fusion Decompression surgical |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 徐建平,易红蕾,李明,石志才,栗景峰,赵颖川,林国兵,王怀云,沈峰.Wallis棘突间动态稳定系统对缓解腰椎融合术后邻近节段退变的临床疗效分析[J].中国骨伤,2013,26(12):1005~1009 |
| 英文格式: | XU Jian-ping,YI Hong-lei,LI Ming,SHI Zhi-cai,LI Jing-feng,ZHAO Ying-chuan,LIN Guo-bing,WANG Huai-yun,SHEN Feng.Clinical application of Wallis interspinous dynamic stabilization in treating adjacent segment degeneration(ASD) after lumbar spinal fusion[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(12):1005~1009 |
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