非融合性棘突间弹性固定治疗腰椎退变性疾病

Clinical outcome of a semi-rigid interspinous fixation with no arthrodesis in the elderly lumebar disease.

目的评价采用非融合性棘突间弹性固定治疗腰椎退行性疾病的早期疗效。方法 2007年8月～2009年9月间,采用美国通用国际医疗器械公司提供的非融合性棘突间弹性固定器Coflex治疗腰椎间盘突出症伴椎管狭窄患者13例,腰椎管狭窄症伴腰椎不稳5例;均采用减压、髓核摘除、棘突间弹性Coflex植入固定治疗。结果 18例腰腿痛患者术后症状明显缓解,患者全部得到了随访,随访3～24个月,平均随访时间为13.5个月,采用VAS(0～10分)评分:术前9.6～6.7(平均8.5),术后0～5.3(平均4.1);术前椎间高度为(10.2±0.64)mm,末次随访时椎间高度为(11.5±0.71)mm。结论术前正确选择合适的患者,术前作好周密的准备,术中规范仔细的操作,术后科学的康复,非融合性棘突间弹性固定治疗腰椎退行性疾病是可选治疗方法。

Objective To assess the availability of the semi-rigid interspinous fixation with no arthrodesis in the elderly lumbar disease.Methods The semi-rigid interspinous fixation（Coflex）with no arthrodesis was used in 18 patients from 8/2007 to 9/2009.Spinal stenosis complex with herniation nucleus pulposus in 13,spinal stenosis complex with vertebral instablility in 5.There is 12 men and 6 women,the average age was 53.5,segment L3/4 in 5 and L4/5 in 13.Results All patients obviously improvement in symptomatology,and followed up form 3 to 24 months,the mean time is 13.5 month.VAS before operation were 6.7～9.6（mean 8.5）,and after operation were 0～5.3（mean 4.1）,height of intervertebral before operation were（10.2±0.64）mm,after last follow up were（11.5±0.71）mm.Conclusion Strict indication,serious preoperation prepare,carefully operation,and scientific postoperative exercise.the semi-rigid interspinous fixation with no arthrodesis could be a choose for elderly lumbar disease.