新型经椎弓根动态稳定系统(K-Rod)治疗腰椎退行性疾病

Clinical study of a new transpedicular dynamic stabilization system(K-Rod) for treating lumbar degenerative disease

[目的]基于临床及影像学观察对K-Rod动态稳定系统的疗效进行评价。[方法]本研究共纳入在2011年2～12月期间行K-Rod系统治疗的患者25例,评价指标主要包括VAS、JOA与ODI评分,以及对患者进行影像学随访观察(包括X线及MRI)。[结果]随访时的VAS评分及ODI均较术前显著降低(P<0.01),JOA评分则显著升高(P<0.01)。随访时手术节段活动度(ROM)较术前显著减少(P<0.01),上位及下位节段的术前ROM与随访ROM比较,无显著差异(P>0.05)。共有7例患者获得了MRI随访,椎间盘Pfirrmann分级显示,3例患者手术节段椎间盘仍有继续退变的表现,大部分患者邻近节段椎间盘信号和高度没有明显改变。[结论]随访结果表明K-Rod动态稳定系统能明显地减轻患者疼痛和功能障碍,同时达到固定和活动的良好平衡,临床效果较为理想。但由于随访时间尚短,研究样本量较小,长期疗效及其延缓邻近节段退变的作用有待进一步观察。

[ Objective] To investigate the efficacy of the K -Rod system in the treatment of degenerative spinal diseases, according to the follow -up research of clinical and imaging observation. [ Methods] The study population included 25 consec- utive patients who underwent decompression and K - Rod stabilization between February 2011 and December 2011. All of the pa- tients completed the visual analogue scale （VAS）, the Japanese Orthopedic Association （JOA） Scale and the Chinese version of the Oswestry Disability Index （ODD at admission and final follow -up. Imaging observation was requested in all patients （in- cluding X ray and MRI） . [ Results] Compared with preoperation, the VAS and ODI of final follow -up both decreased signif- icantly （P 〈0. 001 ）, and the JOA scale also improved （P 〈0. 001 ） . There were statistically significant changes on the ROM at the stabilized segments （P 〈0. 001 ）, but no significant changes were seen at the adjacent segments （above and below seg- ments, P 〉 0.05） . Seven cases completed MRI follow - up, and disc Pfirrmann grading display showed that degeneration of operative intervertebral disc of 3 patients were still continuing. Adjacent segment disc signal and height of the majority of patients did not change significantly. [ Conclusion ~ The follow - up results showed that the dynamic stabilization system of the K - Rod can significantly reduce pain and dysfunction and achieve a good balance of fixed and ideal clinical effect. But due to short follow -up time and small study sample size, we need further study to investigate long -term efficacy and its effect of delaying adja- cent segment degeneration.