Bioflex弹性固定系统治疗中青年腰椎退行性疾病的疗效观察

Short-term curative observation of Bioflex dynamic fixation for treating lumbar degenerative diseases in young and middle-aged patients

目的观察采用Bioflex弹性固定系统治疗青、中年腰椎退行性疾病的短期临床疗效。方法回顾性分析自2011-05—2014-05采用Bioflex弹性固定系统治疗的35例青、中年腰椎退行性疾病。比较术前、术后1周及末次随访时疼痛视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）、固定节段活动度、邻上位节段活动度。结果本组手术时间70-240（138．86±36．70）min，术中出血量100~600（212．86±77．78）ml。35例术后获得随访6～35（21．94±7．74）个月。术后1周VAS评分、ODI指数较术前降低，末次随访时较术后1周较低，差异有统计学意义（P〈0．05）。术后1周固定节段活动度较术前减小（P〈0．05），但仍保留了部分固定节段活动度，且末次随访时固定节段活动度与术后l周比较差异无统计学意义（P〉0．05）。术后1周邻上位节段活动度较术前减小（P〈0．05），但末次随访时略有代偿增加（P〈0．05）。结论采用Bioflex弹性固定系统治疗青、中年腰椎退行性疾病安全、可靠，有效缓解了患者腰背痛，可保留固定节段部分活动度，-定程度上能延缓邻近节段的退变。

Objective To explore and observe the short-term clinical therapeutic effect of the Bioflex dynamic fixation in treatment of young and middle-aged lumbar disc degenerative patients. Methods From May 2011 to May 2014, the clinical data of 35 lumbar degenerative patients who underwent Bioflex dynamic fixation system were retrospectively analyzed. The visual analogue scale （VAS）, the Oswestry disability index （ODI）, the ROM of instrumented segment and the ROM of upper adjacent segment were compared before and a week after surgery, and at the last follow-up respectively. Results The mean operation time of this group was 70-240（138.86±36.70） min, and the intraoperatve blood loss was 100-600（212.86±77.78）ml. Thirty-five patients were followed for average 6-35 （21.94±7.74）months. The VAS and ODI scores decreased significantly at 1 week after surgery compared with those before surgery （P 〈0.05）. The ROM of instrumented segment showed a significant decrease at 1 week after surgery（P 〈0.05）, but still retained a certain activity, and there was no significant difference compared with the last follow-up （P 〉0.05）. The ROM of upper adjacent segment was decreased at 1 week after surgery compared with that before surgery（P 〈0.05）, and at the last follow-up compensatorily increased slightly（P 〈0.05）. Conclusion Bioflex system is a safe and reliable therapeutic measure to treat young and middle-aged lumbar degenerative patients. It can relieve low back pain effectively, and remain a certain activity of the instrumented segment, to some extent, it could prevent the adjacent segment degeneration.