ISOBAR TTL半坚强动态内固定与坚强内固定治疗腰椎退行性疾病临床疗效对比

发布时间：2018-03-25 16:22

本文选题：腰椎退行性疾病　切入点：治疗结果　出处：《吉林大学》2015年硕士论文

【摘要】：目的：比较研究手术治疗腰椎退行性疾病中半坚强固定与坚强固定的疗效,为临床治疗腰椎疾病手术固定方式的选择提供参考。方法：选取2010年10月至2014年10月期间住院的腰椎退行性疾病病人79例，这些全部采用手术治疗。其中采用ISOBAR TTL半坚强动态内固定患者39例，坚强内固定治疗（PLIF）40例，患者随访应用日本矫形外科学会（JOA）评分标准、腰椎活动度(ROM)和影像学评估。术后两组患者的神经功能评分、腰椎活动度等进行比对，P0.05为差异有统计学意义。结果：两组患者全部完成，随访时间为术后3至5年（平均3.2年）。术后一个月、三个月、半年、一年、三年均给予随访及术后JOA评分。所有患者术后神经功能明显改善，末次随访时术后患者JOA评分较术前均有改善，半坚强固定组较坚强固定组术后一个月JOA优良率无明显差异，术后三个月、半年、一年、三年JOA优良率的差异统计意义。术后1年半坚强组的ROM与坚强固定组比较有明显差异。两组在断钉及节段未融合方面无统计学差异，，半坚强内固定组较坚强固定组可明显较少邻近节段退变发生。结论：ISOBAR TTL半坚强动态内固定较坚强固定组术后半年内临床效果无显著差异，半年后有差异。并且可以维持腰椎活动度，减少临近节段退变的发生。因此，ISOBAR TTL半坚强动态内固定组中期临床效果更优，掌握好临床适应症，在临床实践中应用更加广泛。
[Abstract]:Objective: to compare the effect of semi-rigid fixation and rigid fixation in the treatment of lumbar degenerative diseases, and to provide reference for the choice of surgical fixation in the treatment of lumbar degenerative diseases. Methods: from October 2010 to October 2014, 79 cases of lumbar degenerative diseases were selected, all of whom were treated with surgical treatment, including 39 cases of ISOBAR TTL semi-rigid dynamic internal fixation, 40 cases of rigid internal fixation. The patients were followed up with Japanese Orthopaedic Surgical Association (JOAA) score, lumbar motion scale (ROM) and imaging evaluation. There were significant differences in neurological function score and lumbar mobility between the two groups. Results: all the patients in the two groups were followed up for 3 to 5 years (mean 3.2 years). The patients were followed up for one month, three months, six months, one year, three years after operation and JOA score. At the last follow-up, the JOA scores of the patients were improved compared with those of the patients before operation. There was no significant difference in the excellent and good rates of JOA in the semi-rigid fixation group and the strong fixation group at one month after operation. Statistical significance of the difference of excellent and good rate of JOA in three years. There was significant difference in ROM between the two groups one and a half years after operation. There was no significant difference between the two groups in terms of broken nail and unfused segment. The degeneration of adjacent segments in the semi-rigid internal fixation group was significantly less than that in the rigid fixation group. Conclusion there is no significant difference in the clinical effect within half a year after operation in the group of semi-rigid dynamic internal fixation with 1: ISO bar TTL, but there is a difference after half a year, and it can maintain the range of lumbar vertebrae motion. The clinical effect of ISOBAR TTL semi-firm dynamic internal fixation group was better in the middle stage, the clinical indication was grasped well, and its application in clinical practice was more extensive.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

【共引文献】