K-Rod 动态稳定系统与 Dynesys 非融合系统在多节段腰椎退变中的近期疗效比较

Comparison of short-term clinical effect of K - Rod pedicle dynamic fixation system and Dynesys system for multiple segmental lumbar degeneration

目的：探讨比较 K-Rod 椎弓根动态稳定系统与 Dynesys 非融合系统在多节段腰椎退变的近期临床疗效。方法选择2010年1月至2012年10月于沈阳军区总医院行腰椎手术的60例患者，将其分为 K-Rod 组和 Dynesys 组，各30例。K-Rod 组患者行 K-Rod 椎弓根动态稳定系统内固定术，采用责任节段减压椎间融合内固定术、辅助退变节段非融合内固定术；Dynesys 组患者采用后路减压、椎间探查、Dynesys 非融合内固定术。比较两组患者手术前后 Oswestry 功能评分、目测类比评分、术后腰椎动力位 X 线片、腰椎 ROM 值（腰椎屈伸活动度）、手术时间、术中失血量、术后平均住院时间，评估两种术式近期临床疗效。结果两组患者获得12～24个月随访，K-Rod组和 Dynesys 组术后12个月 Oswestry 功能评分、目测类比评分较术前差异均有统计学意义，但两组间术后12个月 Oswestry 功能评分、目测类比评分、平均手术时间、平均失血量、术后平均住院时间比较差异均无统计学意义。结论 K-Rod 椎弓根动态稳定系统与 Dynesys 非融合系统在治疗多节段腰椎退行性疾病可取得满意的近期临床效果，两者均具有术中失血少、手术时间短、术后对腰椎活动度影响小等优点。

Objective To compare the short-term clinical effect of K-Rod pedicle dynamic fixation system and Dynesys system for multiple segmental lumbar degeneration. Methods From January 2010 to October 2012,60 patients with multiple segmental lumbar degeneration who were accepted K -Rod pedicle dynamic fixation system and Dynesys system were retrospectively reviewed.The 60 patients were divided into K - Rod group and fusion group,30 cases of patients with K - Rod pedicle dynamic fixation system who were accepted responsibility segmental decompression intervertebral fusion and internal fixation,degenerative segmental unfusion internal fixation.30 cases with Dynesys system who were accepted posterior decompression,discectomy and Dynesys unfusion internal fixation.Clinical assessments were based on comparion of Oswestry disability index score,visual analogous scale （VAS）,postoperative lumbar hyperextension,hyperbend X-ray film lumbar ROM value （lumbar flexion mobility）,average operation time, intraoperative blood loss,the average length of stay of two groups. Results All of 60 cases were achieved 12 to 24 months follow-up,compared to preoperative,the difference of Oswestry disability index score and visual analogous scale （VAS） for two groups were statistically significant,but the difference of Oswestry disability index score and visual analogous scale （VAS）,average operation time,blood loss, the average length of stay（ALOS） between two groups were unstatistically significant. Conclusion In the treatment of multiple segmental lumbar degeneration,both K - Rod pedicle dynamic fixation system and Dynesys system can obtain satisfactory short-term clinical effect and have advantages of less intraoperative blood loss,shorter operation time,postoperative small effects on lumbar spine mobility.