Isobar TTL系统治疗腰椎退行性疾病的中长期随访结果

发布时间：2018-11-07 16:00

【摘要】：[目的]探讨Isobar TTL内固定系统治疗腰椎退行性疾病的中长期疗效。[方法]回顾性分析因腰椎退行性疾病采用Isobar TTL内固定系统治疗并有2年以上随访的20例患者资料。男11例,女9例;平均年龄43.8岁(26~61岁)。临床疗效采用疼痛视觉模拟评分(visual analog scale,VAS)和Oswestry功能障碍指数(Oswestry disability index,ODI)进行评估。在X线片上分析动态固定节段及其上相邻节段的椎间隙高度、椎间活动度及腰椎前凸角,采用UCLA(University of California at Los Angeles Grading Scale,UCLA)系统评估椎间盘退变情况。在MRI上采用改良Pfirrmmann分级系统评估椎间盘退变情况。[结果]平均随访时间为51.9个月(26~87个月)。所有患者末次随访时VAS评分和ODI评分均较术前明显改善(P0.05),未出现因邻近节段退变性疾病而需要手术的患者。末次随访时动态固定节段的椎间隙高度及椎间活动度较术前减少,差异有统计学意义(P0.05),而椎间盘UCLA评分与术前比较差异无统计学意义(P0.05)。上相邻节段的椎间隙高度、椎间活动度、椎间盘UCLA评分及腰椎前凸角与术前比较差异均无统计学意义(P0.05)。16例患者末次随访时接受腰椎MRI检查,结果提示动态固定节段及上相邻节段的椎间盘改良Pfirrmmann分级与术前比较差异均无统计学意义(P0.05),但其中2例出现邻近节段退变加重。3.2%(4/124)的螺钉出现松动,无内固定断裂、感染等并发症。[结论]Isobar TTL内固定系统治疗腰椎退行性疾病的临床疗效满意,但不能避免动态固定节段出现退变加重。
[Abstract]:[objective] to investigate the long-term efficacy of Isobar TTL internal fixation system in the treatment of lumbar degenerative diseases. [methods] Twenty cases of lumbar degenerative diseases treated with Isobar TTL internal fixation system and followed up for more than 2 years were analyzed retrospectively. There were 11 males and 9 females with an average age of 43.8 years (2660 years). The clinical efficacy was evaluated by pain visual analogue score (visual analog scale,VAS) and Oswestry dysfunction index (Oswestry disability index,ODI). The intervertebral space height, intervertebral motion and lumbar kyphosis angle of the dynamic fixation segment and its upper adjacent segments were analyzed on X-ray film. The degeneration of intervertebral disc was evaluated by UCLA (University of California at Los Angeles Grading Scale,UCLA system. The modified Pfirrmmann grading system was used to evaluate the degeneration of intervertebral disc on MRI. [results] the average follow-up time was 51.9 months (26 ~ 87 months). The VAS score and ODI score of all patients at the last follow-up were significantly improved compared with those before operation (P0.05). There were no patients who needed surgery because of adjacent degenerative disease. At the last follow-up, the intervertebral space height and intervertebral motion decreased significantly (P0.05), but the UCLA score of intervertebral disc had no significant difference (P0.05). There was no significant difference in intervertebral space height, intervertebral movement, intervertebral disc UCLA score and lumbar kyphosis angle between the upper and the adjacent segments (P0.05). MRI examination was performed in 16 patients at the last follow-up. The results showed that there was no significant difference in the modified Pfirrmmann grade of intervertebral disc between the dynamic fixed segment and the upper adjacent segment (P0.05). But in 2 cases, adjacent degenerative aggravation occurred, 3. 2% (4 / 124) screws loosened, no internal fixation breakage, infection and other complications. [conclusion] Isobar TTL internal fixation system is effective in the treatment of lumbar degenerative diseases, but it can not avoid degeneration and aggravation of dynamic fixation.
【作者单位】：南方医科大学南方医院脊柱骨科;
【分类号】：R681.53

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