聚醚醚酮棒椎弓根内固定系统在腰椎退行性疾病治疗中的应用

目的分析聚醚醚酮棒（PEEK棒）椎弓根螺钉内固定系统在治疗腰椎退行性疾病中的应用可行性。方法对比分析分别采用PEEK棒内固定（P组，13例）及传统钛棒固定（T组，15例）后路椎管减压椎体间融合治疗腰椎退行性病变的两组患者的资料，通过日本骨科学会（JOA）评分评价临床疗效，并比较两组间手术时间、术中输血量、以及末次随访时椎间融合率及相关并发症。结果所有患者术后均经过6个月以上的随访。P组术前JOA评分10．53±1．90，术后为24．1±1．93，手术前后JOA评分改善率为（73．7±9．33）％；T组术前JOA评分为9．33±1．95，术后为23．7±1．83，手术前后JOA评分改善率为（73．3±9．15）％，差异无统计学意义（P=0．891）。植骨融合情况：P组9例为1级，4例为2级；T组15例中5例为1级，7例为2级，3例为3级，差异有统计学意义（P=0．036）。结论PEEK棒椎弓根螺钉内固定与坚强内固定治疗腰椎退行性疾病相比，短期可取得相同的疗效。PEEK棒组的骨融合率要高于传统钛棒组。PEEK棒治疗腰椎退行性疾病的长期临床效果尚有待进一步观察。

Pedical dynamic internal fixation using polyetheretherketone rods for the treatment of degenerative lumbar diseases

Objective To investigate the feasibility of pedical dynamic internal fixation by using polyelheretherketone （PEEK） rods for the treatment of degenerative lumbar diseases. Methods Effects of treatment using PEEK rods （group P, n=13） and conventional titanium rod fixation （group T, n=15） , namely the posterior lumbar vertebral fusion, on patients with degenerative lumbar diseases were compared. The clinical efficacy was assessed based on Japanese Orthopaedic Association （JOA） scoring. The duration of operation, volume of blood transfusion during surgery, bone fusion rate at the final visit and relevant complications were also compared. Results All patients were followed-up for a minimum of 6 months. Group P had mean JOA score of 10.53＋ 1.90 and 24.1 ＋ 1.93 pre-operatively and post-operatively, and these figures were 9.33±1.95 and 23.7± 1.83 in group T, respectively. Improvement rates of groups P and T were （73.7±9.33）% and （73.3_＋9.15）%, respectively （P=0.891）. Group P differed significantly （P=0.036） in terms of bone fusion rate （9 for grade 1 and 4 for grade 2） as compared with that of group T （5 for grade 1, 7 for grade 2 and 3 for grade 3）. Conclusions Pedical dynamic internal fixation using PEEK rods has some result of titanium rod fixation for short-term treatment of degenerative lumbar diseases. Although PEEK rod treatments has higher fusion rate, long-term efficacy remains to be further studied.