设为首页 加入收藏 登录旧版
不同活动度Isobar动态固定系统对术后腰椎间盘影响的对比研究
Comparative study on the effect of Isobar dynamic fixation system with different activities on lumbar intervertebral disc
投稿时间:2022-01-27  修订日期:2022-06-18
DOI:10.3969/j.issn.1672-5972.2022.06.010
中文关键词:  Isobar TTL动态内固定系统  Isobar EVO动态内固定系统  腰椎退行性疾病  动态稳定  腰椎间盘突出  核磁共振
英文关键词:Isobar TTL dynamic internal fixation system  Isobar EVO dynamic internal fixation system  Lumbar degenerative diseases  Dynamic stability  Lumbar disc protrusion  MRI
基金项目:横向课题(仿生矿化胶原人工骨在脊柱疾病及骨折治疗中的疗效观察)
作者单位E-mail
关健斌 北京中医药大学北京100029 346421164@qq.com 
刘涛 北京中医药大学北京100029  
俞兴 北京中医药大学附属东直门医院骨三科北京100700 yuxing34@sina.com 
冯宁宁 北京中医药大学北京100029  
姜国正 北京中医药大学北京100029  
杨永栋 北京中医药大学附属东直门医院骨三科北京100700  
赵赫 北京中医药大学附属东直门医院骨三科北京100700  
摘要点击次数: 180
全文下载次数: 157
中文摘要:
      目的 对比TTL系统(一代Isobar系统)和Isobar EVO系统(二代Isobar系统)对手术和邻近节段椎间盘的影响。方法 回顾性分析北京中医药大学附属东直门医院骨三科2016年8月至2019年8月,共计63例采用Isobar动态固定系统联合减压治疗的腰椎退行性疾病患者的临床资料,将患者分为TTL组(34例)和EVO组(29例),对比各时间点两组VAS评分和ODI指数,手术节段及上邻节段椎间高度指数(DHI)、上邻节段髓核容积(LNPV)和椎间盘退变Pfirrmann分级情况的变化情况。结果 TTL组随访21 ~ 28个月,平均(26.32±2.15)个月;EVO组随访21 ~ 30个月,平均(25.46±4.43)个月。两组患者的VAS评分、ODI指数较术前明显改善,差异有统计学意义(P<0.05);但两组间术后1年、末次随访的VAS评分、ODI指数比较,差异无统计学意义(P>0.05)。TTL组术后1年及末次随访的手术节段和上邻节段DHI与术前比较,差异无统计学意义(P>0.05);EVO组术后1年及末次随访的手术节段DHI较术前增高(P<0.05),而上邻节段EVO组与术前比较,差异无统计学意义(P>0.05);两组间比较,EVO组末次随访的手术节段DHI较TTL组增高(P<0.05)。TTL组术后1年及末次随访上邻节段LNPV与术前比较,差异无统计学意义(P>0.05);EVO组较术前均有所增高(P>0.05);两组间上邻节段LNPV比较,差异无统计学意义(P>0.05)。TTL组末次随访手术节段和上邻节段Pfirrmann分级变化情况与术前相比变化不明显(P>0.05);而EVO组与术前相比,差异有统计学意义(P<0.05)。结论 应用Isobar EVO动态内固定系统对腰椎退行性疾病进行非融合治疗临床疗效满意,在短期内可能延缓固定节段和邻近节段椎间盘退变,对退变的椎间盘起到一定的保护作用。
英文摘要:
      Objective To explore the effect of Isobar dynamic fixation system with different activities on surgical segments and adjacent segments of intervertebral discs through the change of MRI.Methods From August 2016 to August 2019, 63 patients with lumbar degenerative diseases were treated with Isobar dynamic fixation system combined with decompression at the third department of orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine. The patients were divided into TTL group (34 cases) and EVO group (29 cases). At each time point, the changes in VAS and ODI, disc height index (DHI) of the operative segment and upper adjacent segment, lumbar nucleus pulposus volume (LNPV) of the upper adjacent segment, and Pfirrmann grade of intervertebral disc degeneration were compared between the two groups.Results The TTL group was followed up for 21-28 months, with an average of (26.32±2.15) months; the EVO group was followed up for 21-30 months, for an average of (25.46±4.43) months. There was no significant difference in VAS and ODI between the two groups at 1 year after operation, and the last follow-up (P>0.05). Compared with preoperation, there was no significant difference in the DHI between operative segments and upper adjacent segments in TTL group at 1 year after operation and the last follow-up (P>0.05); the DHI of the operative segments in the EVO group at 1 year after operation and the last follow-up were significantly higher than preoperation (P<0.05), the DHI of upper adjacent segments in the EVO group increased 1 year after operation and the last follow-up (P<0.05); the DHI of the operative segments at the last follow-up of the EVO group was significantly higher than that of the TTL group (P<0.05). Compared with preoperation, there was no significant difference in the LNPV of upper adjacent segments in TTL group and EVO group at 1 year after operation and the last follow-up (P>0.05); the LNPV in the EVO group was larger than that of the TTL group at 1 year after operation and the last follow-up (P>0.05). Pfirrmann grade of intervertebral disc degeneration: Compared with preoperation, there was no significant difference in the grade change of the operative segments and the upper adjacent segments in TTL group at the last follow-up (P>0.05); in EVO group, there was significant difference in grade change between the last follow-up and preoperation (P<0.05).Conclusion The clinical efficacy of the Isobar EVO dynamic internal fixation system in the non-fusion treatment of lumbar degenerative diseases has been demonstrated. It may slow the degeneration of intervertebral discs at fixed and adjacent segments and play a protective role in degenerative intervertebral discs.
查看全文  查看/发表评论  下载PDF阅读器
扫码关注
《生物骨科材料与临床研究》微信公众号