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后路非融合固定在腰椎间盘退变性疾病中的临床应用
引用本文:龙厚清,Kazumasa Ueyama,刘少喻,李佛保,万勇,陈立言,廖威明.后路非融合固定在腰椎间盘退变性疾病中的临床应用[J].中国骨与关节损伤杂志,2008,23(6):453-455.
作者姓名:龙厚清  Kazumasa Ueyama  刘少喻  李佛保  万勇  陈立言  廖威明
作者单位:1. 中山大学附属第一医院脊柱外科,广东省广州市,510700
2. 日本弘前大学弘前记念病院
摘    要:目的评估后路非融合固定(Graf技术)应用于腰椎间盘退变性疾病的疗效。方法分析13例非融合固定(A组)和21例融合固定(B组)治疗单节段腰椎退行性病变的临床和影像学资料。视觉模拟评分(VAS)、日本整形外科学会(JOA)评分和ODI功能评价评估临床疗效,腰椎过伸和过屈、侧位X线片评估腰椎活动度和腰椎前凸角(Cobbs法),观察两组手术并发症。结果平均随访19个月(12~29个月),末次随访A、B两组VAS评分分别由术前9.4、9.1分减少到2.1、3.6分;JOA评分均显著优于术前(P<0.001),两组无显著性差异(P>0.05);A组术后ODI优良率93%,B组71%,A组显著优于B组(P<0.05)。结论后路非融合固定是治疗腰椎间盘退变性疾病的有效方法,与融合固定相比,可以获得满意的临床疗效和保留一定的腰椎活动度。

关 键 词:腰椎间盘退变性疾病  非融合固定  融合
修稿时间:2007年6月6日

Clinical Outcomes of Posterior Dynamic Fixation for Lumbar Degenerative Disc Disease
Kazumasa Ueyama.Clinical Outcomes of Posterior Dynamic Fixation for Lumbar Degenerative Disc Disease[J].Chinese Journal of Bone and Joint Injury,2008,23(6):453-455.
Authors:Kazumasa Ueyama
Abstract:Objective To assess the efficacy of posterior dynamic fixation-Graf ligamentoplasty comparison with rigid fixation for the degenerative disc disease.Methods The clinical and radiographic results of 13 patients with dynamic fixation and 21 patients with rigid instrumentation for one-level lumbar degenerative disc disease were evaluated.Visual analogue pain scale(VAS,10 points),Japanese orthopeadic association(JOA,29 points),and Oswestry disability index(ODI) were used for clinical evaluation.Cobbs method was used for lumbar range of motion(ROM) measurement on dynamic lateral X-ray films.Complications related to operation were also considered.Results The follow-up period ranged from 12 to 29 months(average 19 months).The pre-operative and post-operative VAS was 9.4(A)/9.1(B) and 2.1(A)/3.6(B) respectively.The mean JOA score at the final follow-up was significantly higher than the pre-operative score(P<0.001).There was no significant difference between group A and B(P>0.05).Group A patients had a satisfactory outcome compared to group B measured by ODI(P<0.05).Conclusion The stabilization by Graf ligamentoplasty has some advantages over lumbar fusion by rigid fixation regarding clinical results and lumbar ROM.It is a worthwhile procedure for one level degenerative disc disease if the patients are selected properly.
Keywords:Lumbar degenerative disc disease  Dynamic fixation  Fusion
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