Bioflex动态内固定术治疗腰椎退变性疾病的中期临床疗效

Bioflex dynamic fixation treatment of lumbar degenerative disease in the middle of curative effect

目的：对比 Bioflex 动态内固定术与经后路椎体间融合术（PLIF）治疗单节段腰椎退变性疾病的中期临床疗效．方法：收集我院行 Bioflex 动态内固定术（Bioflex 组）治疗单节段腰椎退变性疾病28例，经后路椎体间融合术（PLIF 组）37例，比较 Bioflex 组与 PLIF 组手术时间、术中出血量、术后引流量等临床资料；术前及术后末次随访的 Oswestry 功能障碍指数（ODI）、视觉模拟评分法（VAS）手术节段及其上邻节段活动度（Range of motion，ROM），评估两组临床疗效．结果：随访24～48个月，平均36．8个月，Bioflex 组手术时间、术中出血量、术后引流量较 PLIF 组少（P ＜0.05）．末次随访时：两组 VAS 评分、ODI 评分均较术前有明显改善（P ＜0.05）；两组手术节段 ROM较术前减小（P ＜0.05），Bioflex 组手术节段 ROM较 PLIF 组大（P ＜0.05）；两组术后上邻近节段 ROM较术前增大（P ＜0.05），Bioflex 组术后上邻近节段 ROM比 PLIF 组小（P ＜0.05）．结论：Bioflex 动态内固定术治疗单节段腰椎退变性疾病的中期临床疗效满意．与传统术式 PLIF 比较，Bioflex 动态固定能够部分保留手术节段 ROM，不增加上邻节段 ROM，同时具有手术时间短、术中出血少、术后引流少的优势．

Aim：To study the therapeutic effect of the Bioflex dynamic fixation in treatment of segmen-tal lumbar degenerative disease.Methods：Total of 65 consecutive patients with degenerative lumbar dis-ease met the strict inclusion and exclusion criteria,28 patients were treated with Bioflex dynamic fixation group,37patients underwent rigid fixation and fusion PLIF,The clinical efficacy was evaluated by observ-ing clinical data such as VAS score,ODI score,operativing time,blood loss,and imaging features such as the intervertebral range of motion.Results：All patients follow-up for 24 to 48 months （mean 36.8 months）,The operating time,blood loss,postoperative drainage in the Bioflex were significant lower than those in the group of PLIF group（P 〈0.05）.VAS、ODI of the final follow-up were significant lower than＆nbsp;that of pre-operation in both groups（P 〈0.05 ）;Two groups of instrumented segments ROM operation showed significant less（P 〈0.05）,the instrumented segmental ROM of Bioflex group were higher than the PLIF group（P 〈0.05）;But the adjacent segment ROMof PLIF Group was higher than before opera-tion（P 〈0.05）;the adjacent segment of Bioflex group was lower than group PLIF（P 〈0.05）.Conclu-sion：Bioflex dynamic fixation is satisfactory in treatment of lumbar degenerative disease.Compared with the traditionnal PLIF,Bioflex dynamic fixation can preserves functional motion to some degree,also pre-vent adjacent segment ROMfrom increasing,at the same time,it has the many advantages,such as shor-ter operating time,less bleeding and postoperative drainage.