Waveflex弹性固定与髓核摘除纤维环修复重建腰椎间盘突出患者脊柱稳定性

背景：青壮年腰椎间盘突出症患者因其病理的特殊性，对治疗要求更高，传统的髓核摘除及刚性固定融合存在相应的并发症，临床满意率不高。Waveflex是一种非融合椎弓根螺钉半刚性固定系统，结合纤维环修复技术，可维持节段间正常运动，提高临床满意率。目的：对后路Waveflex非融合椎弓根螺钉弹性固定小开窗髓核摘除结合纤维环修复治疗青壮年腰椎间盘突出症进行短期疗效评价。方法：纳入青壮年腰椎间盘突出症患者38例，其中弹性固定组18例行腰椎后路小开窗髓核摘除纤维环修复结合Waveflex弹性固定，髓核摘除组20例行单纯髓核摘除。随访分析患者疗效和并发症，定期进行腰痛目测类比评分、下腰痛日本骨科协会评分(JOA)、Oswestry功能障碍指数(ODI)评估，并复查腰椎正侧位X射线片测量相关指标。结果与结论：患者治疗后随访12-20个月。两组末次随访时腰痛目测类比评分、下腰痛JOA评分、腰痛ODI均优于治疗前(P < 0.05)；动态固定组末次随访腰痛目测类比评分、下腰痛JOA评分、腰痛ODI评分优于髓核摘除组(P < 0.05)。末次随访中，弹性固定组手术节段的椎间隙高度大于治疗前，而手术节段活动范围较治疗前减小(P < 0.05)。提示与传统髓核摘除相比，Waveflex系统结合髓核摘除纤维环修复治疗青壮年腰椎间盘突出症的早期腰椎功能恢复更为满意，且对手术节段稳定性有积极作用。中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Waveflex elastic fixation and discectomy annulus in repair and reconstruction of spinal stability in patients with lumbar disc herniation

BACKGROUND: For reason of pathological particularity, treatments for young adult patients with lumbar disc herniation require more demanding procedures. Traditional discectomy and rigid fixation and fusion receive a lower clinical satisfaction rate because of their concomitant complications. Waveflex is a semi-rigid fixation system with non-fusion pedicle screws. Once combined with the technology of annulus repair, it can maintain the normal movement of the segments, and can thus raise clinical satisfaction rate.