腰椎退变不稳行单侧钉棒固定纳米骨与聚醚醚酮椎间融合疗效对比

发布时间：2019-04-26 14:49

【摘要】：目的:探讨人造纳米骨椎间融合器与聚醚醚酮椎间融合器治疗退变性腰椎不稳的术后疗效。方法:选取64例退变性腰椎不稳患者分两组,A组34例,应用聚醚醚酮椎间融合器治疗;B组30例,应用人造纳米骨(n-HA/PA66)融合器治疗。两组分别于术前及手术治疗后1周、1、6、12、18个月随访,同时针对各组进行相应影像学检查,以及椎间隙相对高度、植骨融合率以及VAS评分、ODI评分、JOA评分以及手术并发症发生率和不良比率进行比较。结果:1.各组术前、手术治疗后椎间隙相对高度有显著差异,随访两组之间手术治疗后6月、手术治疗后12月、手术治疗后18月,并对两组椎间隙相对高度进行统计学比较,P0.05,结合患者术后恢复情况,说明聚醚醚酮组较国纳科技生产的人造纳米骨(n-HA/PA66)组椎间隙相对高度丢失明显;2.各组术前、手术治疗后VAS评分、ODI评分JOA评分以及临床疗效的优良比率有显著差异,而随访两组之间手术治疗后6月、手术治疗后12月、手术治疗后18月两组腰痛VAS评分、ODI评分JOA评分比较P0.05,说明国纳科技生产的人造纳米骨(n-HA/PA66)组较聚醚醚酮组患者手术治疗后腰痛恢复、功能障碍恢复明显。3.两组植骨融合率无明显差异,但国纳科技生产的人造纳米骨(n-HA/PA66)组较聚醚醚酮组达到椎间融合所需的时间短。4.临床疗效的优良比率无显著差异,说明两种融合器治疗具有相同的临床疗效;结论:1、与聚醚醚酮材料相比,国纳科技生产的人造纳米骨(n-HA/PA66)具有在远期能够更好地恢复椎间隙相对高度、达到椎间融合所需的时间较少,手术治疗后疼痛症状缓解以及手术治疗后患者功能障碍恢复,人造纳米骨(n-HA/PA66)椎间融合器较醚醚酮椎间融合器更为适宜。2、两种方式在椎体融合率方面比较无显著差异,但国纳科技生产的人造纳米骨(n-HA/PA66)组较聚醚醚酮组达到椎间融合所需的时间较少。3、作为腰椎不稳椎间融合植骨材料,聚醚醚酮与国纳科技生产的人造纳米骨(n-HA/PA66)均能有效的治疗腰椎不稳,其它相关临床症状相比较无显著差异。
[Abstract]:Objective: to investigate the effect of artificial nano-bone interbody fusion cage and polyether ether ketone interbody fusion cage in the treatment of degenerative lumbar instability. Methods: sixty-four patients with degenerative lumbar instability were divided into two groups: group A (n = 34) treated with polyether ether ketone interbody fusion cage and group B (n = 30) treated with artificial nano-bone (n-HA/PA66) fusion cage. The patients in the two groups were followed up for 1 week, 1 week, 6 months, 12 months and 18 months before and after operation respectively. The corresponding imaging examination, the relative height of intervertebral space, the fusion rate of bone graft, the VAS score and ODI score of each group were carried out at the same time. JOA scores, operative complications and adverse rates were compared. Results: 1. There were significant differences in the relative height of the intervertebral space between the two groups before and after the operation. 6 months after the operation, 12 months after the operation and 18 months after the operation, the relative height of the intervertebral space between the two groups was compared statistically (P 0.05, P < 0.05), and the relative height of the intervertebral space between the two groups was significantly higher than the control group. According to the recovery of the patients after operation, the relative height loss of vertebra space in the polyether ether ketone group was significantly higher than that in the synthetic nano-bone (n-HA/PA66) group produced by Guona science and technology. 2. There were significant differences in VAS score, ODI score, JOA score and excellent rate of clinical curative effect among the groups before operation and after operation, but the VAS score of lumbago between the two groups was 6 months after operation, 12 months after operation and 18 months after operation, and there was significant difference between the two groups in the follow-up of 6 months, 12 months and 18 months after operation. The comparison of JOA score of ODI score with P0.05 indicates that the artificial nano-bone (n-HA/PA66) group produced by Guona Science and Technology has better recovery of low back pain and obvious recovery of dysfunction after operation than that of polyether ether ketone group. There was no significant difference in bone graft fusion rate between the two groups, but the time required for interbody fusion in n-HA/PA66 group was 4. 4% shorter than that in polyether ether ketone group. There was no significant difference in the excellent rate of clinical curative effect, indicating that the two kinds of fusion devices had the same clinical curative effect. Conclusion: 1. Compared with polyether ether ketone (Polyether ether ketone), the synthetic nano-bone (n-HA/PA66) produced by Guona science and technology can recover the relative height of intervertebral space better in the long term, and it takes less time to achieve interbody fusion. Compared with ether ketone interbody fusion cage, artificial nano bone (n-HA/PA66) interbody fusion cage is more suitable than ether ketone interbody fusion cage for relief of pain symptoms and recovery of dysfunction after surgical treatment. There was no significant difference between the two methods in vertebral fusion rate, but it took less time to achieve interbody fusion in n-HA/PA66 group than that in polyether ether ketone group. As bone graft material for lumbar instability fusion, polyether ether ketone (PEK) and synthetic nano-bone (n-HA/PA66) produced by Guona technology can effectively treat lumbar instability, and there is no significant difference in other related clinical symptoms.
【学位授予单位】：河南大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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