脊柱非融合U型棘突间钛合金材料植入治疗早期腰椎间盘突出伴

背景：脊柱非融合技术是目前对于早期脊柱疾病进行干预的新技术，可以在保护脊柱运动功能的同时达到治疗患者病情的效果。U型棘突间钛合金材料植入物属于后路棘突间非融合新技术范畴，此方面的研究将是非融合技术的一个热点。 目的：观察腰椎后路动态腰椎管狭窄运动保留的非融合U型棘突间钛合金材料植入物的临床力学性能。 设计、时间及地点：对比观察，病例来自2006-06/2007-12上海长海医院骨科。 对象：选择退变性椎间盘突出伴有动态椎管狭窄的患者28例，男23例，女5例，年龄41~58岁。 方法：根据患者自愿的方式随机分为2组，单纯椎间盘摘除减压组(n=20)：单纯椎间盘摘除减压术摘除责任节段椎间盘；材料植入物组(n=8)：先摘除责任节段椎间盘后去除棘突间韧带，将2个翼状突起夹在头尾端棘突上，然后在棘突间植入U型棘突间钛合金材料植入物。 主要观察指标：术后及随访测量责任节段的椎间隙高度保护度、椎管面积以及患者的腰椎JOA评分。 结果：28例退变性椎间盘突出伴有动态椎管狭窄患者均进入结果分析。材料植入物组植入U型钛合金材料后椎间隙高度保护度和平均椎管面积较单纯椎间盘摘除减压组明显增加(P < 0.05)。患者腰椎手术前后的JOA评分均有明显改善，但是采用非融合技术材料植入物组的改善程度明显优于常规单纯椎间盘摘除减压组(P < 0.05)。 结论：脊柱非融合U型棘突间钛合金材料植入物对于早期椎间盘突出伴有动态腰椎管狭窄患者的腰椎力学性能有很好的保护作用。

Spinal nonfusion interspinous U titanium alloy for early degenerative intervertebral disk protrusion and dynamic spinal stenosis: Mechanical properties of the lumbar vertebra

BACKGROUND: The new technique of spinal nonfusion is used for intervention of early spinal diseases. It can protect the spine motion function and treat the patients either. The interspinous U titanium alloy belongs to the new technique of spinal nonfusion. And this investigation will be a hot spot in the spinal nonfusion technique. OBJECTIVE: To explore the clinical mechanical property of spinal nonfusion interspinous U titanium alloy. DESIGN, TIME AND SETTING: Comparative observation. All patients were selected from the Department of Orthopaedics of Changhai Hospital between June 2006 and December 2007. PARTICIPANTS: A total of 28 patients with degenerative intervertebral disk protrusion and dynamic spinal stenosis, including 23 male and 5 female aged 41 to 58 years old. METHODS: All patients were randomly divided into two groups: intervertebral disectomy alone (n=20): affected segments were removed; implantation group (n=8): affected segments were removed and interspinous U titanium alloy was implanted following interspinous ligament. MAIN OUTCOME MEASURES: The height of the intervertebral space and vertebral canal area of the affected segment as well as JOA scores for lumbar vertebra postoperatively and during follow-up. RESULTS: All 28 patients were included in the final analysis. The height of the intervertebral space and vertebral canal area of the affected segment in implantation group were significantly increased compared with intervertebral disectomy alone group (P < 0.05). JOA scores of both groups were increased, but the implantation group was significantly greater than intervertebral disectomy alone group (P < 0.05). CONCLUSION: The interspinous U titanium alloy implant can protect the mechanical property of lumbar vertebrae of patients with degenerative intervertebral disk protrusion and dynamic spinal stenosis.