摘要
目的通过将L4/5节段Coflex植入内固定与单节段融合术治疗腰椎间盘突出及腰椎管狭窄症的临床疗效及邻近节段退变情况的比较，比较Coflex等非融合理念用于中年患者的优势。方法随访2008年5月．2010年5月间在我科行L。单节段Coflex植入术与L4/5单节段腰椎椎间融合术的患者，年龄限制在40-60岁。其中Colfex组患者48例，融合组患者52例。统计两组患者围手术期相关数据，对比两组患者在手术时间、出血量及平均住院天数的差异。记录术前术后患者的日本骨科学会评分值（JOA）、功能障碍指数（ODI）及视觉评分量表（VAs）评分值。在术前及术后的站立侧位片上测量邻近节段椎间隙高度变化，在过伸过屈动力位片上测量邻近节段椎间活动度。结果两组患者术前及末次随访时JOA、ODI及VAS评分值的差异无统计学意义。Coflex组患者平均手术时间、手术出血量及平均住院天数均显著小于融合组。Coflex组患者术后早期疼痛较轻。Coflex组患者术后上下邻近节段的活动度与术前对比其差异无统计学意义，融合组患者术后上下邻近节段的活动较角术前有明显增加，差异有统计学意义。结论对于40～60岁的中年患者，单节段Coflex与融合术均能取得满意的术后疗效，但Coflex手术时间更短，术后恢复更快，且能有效的保护邻近节段的退变。
Objective To compare the clinical effectiveness and adjacent segment degeneration of posterior decompression combined with Coflex interspinous dynamic reconstruction or lumbar intervertebral fusion for degenerative lumbar spinal disorders. Methods The patients with the age ranging from 40 to 60 that received the coflex implantation and lumbar intervertebral fusion at L4/5 were retrospectively investigated from May, 2008 to May, 2010.There were 48 cases in group coflex with an average age of 48.7 and an average follow-up of 34.6 months. There were 52 cases in group fusion with an average age of 49.5 and an average follow-up of 37.4 months. Compare the difference in surgical duration, blood loss and hospitalization length between two groups. The JOA score, VAS score and ODI score were preoperatively compared and postoperatively compared at follow-up. The range of motion （ROM） and intervertebral height of affected adjacent segments were measured before operation and last follow-up. Results There were not statistical differences at JOA score, ODI score and VAS score between two groups prior to surgery and at last follow-up. Compared with the fusion group, the Coflex group had shorter surgical duration, less blood loss and shorter hospitalization length. Patients in the fusion group had a larger range of motion at adjacent segments. There was no statistic difference in the intervertebral height between pre- and post-operation in both groups. Conclusions Treating degenerative lumbar spinal disorders on people with age between 40-60 can achieve good clinical results by the use of Both Coflex interspinous dynamic reconstruction and lumbar intervertebral fusion. However, using the coflex implantation have shorter surgical duration and quicker recover, which can also protect the adjacent segments effectively.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2014年第1期98-101,共4页
Chinese Journal of Clinical Anatomy
