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Bioflex动态稳定系统在多节段腰椎退行性疾病中的应用
Hits: 2759   Download times: 1376   Received:December 15, 2010    
作者Author单位UnitE-Mail
李大伟 LI Da-wei 解放军309医院骨科, 北京 100091 Department of Orthopaedics, the 309th Hospital of the PLA, Beijing 100091, China  
马远征 MA Yuan-zheng 解放军309医院骨科, 北京 100091 Department of Orthopaedics, the 309th Hospital of the PLA, Beijing 100091, China myzzxq@sina.com 
胡明 HU Ming 解放军309医院骨科, 北京 100091 Department of Orthopaedics, the 309th Hospital of the PLA, Beijing 100091, China  
罗展鹏 LUO Zhan-peng 解放军309医院骨科, 北京 100091 Department of Orthopaedics, the 309th Hospital of the PLA, Beijing 100091, China  
罗小波 LUO Xiao-bo 解放军309医院骨科, 北京 100091 Department of Orthopaedics, the 309th Hospital of the PLA, Beijing 100091, China  
期刊信息:《中国骨伤》2011年24卷,第4期,第286-289页
DOI:10.3969/j.issn.1003-0034.2011.04.005


目的:探讨Bioflex动态稳定系统在多节段腰椎退行性疾病中的应用价值。

方法:回顾性分析2008 年4月至2009 年5月收治的多节段腰椎退行性疾病患者13例, 男8例, 女5例;年龄51~72岁, 平均65.0岁。病变节段:L3,4、L4,5、L5S1 7例, L2,3、L3,4、L4,5、L5S1 3例, L3,4、L4,5 1例, L4,5、L5S1 2例。手术方法:椎管减压、Bioflex系统固定、根据椎间盘退变程度选择椎体间融合或不融合。观察疼痛视觉模拟评分(visual analog scale, VAS), Oswestry功能障碍指数(Oswestry disability index, ODI), 节段活动范围(range of motion, ROM), 椎间融合节段的融合情况。

结果:术后经12~26 个月随访, 平均19.5个月。手术时间90~240 min, 平均183.4 min, 术中出血量400~1 220 ml, 平均 610.2 ml.术前VAS为(7.8±1.3)分, 术后为(2.3±0.9)分, 末次随访为(2.1±0.8)分;术前ODI为(60.50±4.40)%, 术后为(17.80±2.10)%, 末次随访为(16.20±2.40)%.与术前比较, 术后VAS、ODI差异均具有统计学意义(P<0.05), 术后与末次随访结果无明显差异(P>0.05).手术前后ROM:整个腰椎和非融合节段活动度明显减低, 邻近节段略增加。融合节段融合率95.0%(19/20).

结论:Bioflex系统固定结合椎体间融合是治疗多节段腰椎退行性疾病的一种安全、有效的外科方法, 远期效果待进一步观察。
[关键词]:退行性疾病  减压  动态固定  脊柱融合术  脊柱非融合术
 
Application of Bioflex dynamic stabilization system in treating multi-segment lumbar degenerative disease
Abstract:

Objective: To explore the value of application of Bioflex dynamic stabilization system in treating multi-segment lumbar degenerative disease.

Methods: Clinical datas of 13 patients with multi-segment lumbar degenerative disease(8 males and 5 females, ranging in age from 51 to 72 year with an average of 65.0) were retrospectively analyzed between April 2008 and May 2009. The involved area included L3-S1 in 7 cases, L2-S1 in 3 cases, L3-L5 in 1 cases, L4-S1 in 2 cases. All patients underwent decompression, dynamic stabilization with Bioflex system, according to the severity of degenerative disc with/without interbody fusion. The clinical effects were evaluated by VAS, ODI. ROM and fusion segments were also observed.

Results: The mean follow up period was 19.5 months(from 12 to 26 months). The mean operative time was 183.4 min (from 90 to 240 min) and the mean volume of blood loss was 610.2 ml(from 400 to 1 220 ml). The mean VAS score was 7.8±1.3 preoperatively, 2.3±0.9 postoperatively and 2.1±0.8 at the last follow up. The average ODI was(60.50±4.40)% preoperatively, (17.80±2.10)% postoperatively and (16.20±2.40)% at the last follow up.The VAS and ODI significant improved in postoperatively(P<0.05), and there was no statistical difference between postoperative and last follow up (P>0.05). ROM of whole lumbar and non-fused segment showed obviously decreased and adjacent segment showed insignificant increased. The fusion rate of interbody fusion level was 95.0%(19/20).

Conclusion: The preliminary clinical results show the Bioflex system combined with intebody fusion is a safe and effective technique in treating multi-segment lumbar degenerative disease.
KEYWORDS:Degenerative disease  Dynamic fixation  Decompression  Spinal fusion  Spinal non-fusion
 
引用本文,请按以下格式著录参考文献:
中文格式:李大伟,马远征,胡明,罗展鹏,罗小波.Bioflex动态稳定系统在多节段腰椎退行性疾病中的应用[J].中国骨伤,2011,24(4):286~289
英文格式:LI Da-wei,MA Yuan-zheng,HU Ming,LUO Zhan-peng,LUO Xiao-bo.Application of Bioflex dynamic stabilization system in treating multi-segment lumbar degenerative disease[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(4):286~289
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