X-Stop及Wallis系统植入对腰椎结构的影响比较

Comparison of Lumbar Changes after X-Stop System and Wallis System Implantationm

目的比较X-Stop及Wallis系统内固定植入对腰椎间盘退变性疾病患者腰椎结构的影响。方法 2011年12月至2015年12月期间收治腰椎间盘退行疾病患者80例,依据随机数字表法将患者分为两组:A组40例患者病变节段减压后植入X-Stop系统,B组40例病变节段减压后植入Wallis系统,比较两组患者的手术疗效及腰椎结构变化。结果两组患者手术时间和出血量差异无统计学意义(P>0.05),但A组内固定植入时间显著低于B组(P<0.05);两组患者治疗后VAS评分和ODI评分显著下降(P<0.05),但组间差异无统计学意义(P>0.05);手术后,两组患者的Cobb角、椎间孔横径/下位椎体高度、椎间孔纵径/下位椎体高度和椎间隙高度/下位椎体高度显著增加(P<0.05);A组患者术后椎间隙高度/下位椎体高度显著高于B组,差异具有统计学意义(P<0.05);两组患者术后L_(4~5)节段活动度ROM值降低(P<0.05),但B组下降更为明显(P<0.05);两组患者手术前后颅侧和尾侧的Woodend评分无明显变化(P>0.05),组间比较差异无统计学意义(P>0.05)。随访1年,两组患者的手术效果满意,恢复良好,均无感染、神经损伤、内固定断裂或松动、硬膜囊破裂等并发症发生。结论 X-Stop及Wallis系统内固定植入均能有效恢复患者腰椎生理曲度,增加椎间隙高度和椎间孔面积,安全性和有效性良好,但X-Stop在增加椎间隙高度方面效果更优,操作更为简便。

Objective To compare the postoperative changes of lumbar structure after implanting X-Stopsystem and Wallis system.Methods 80 patients with lumbar degenerative disc disease from December 2011 to December 2015 were randomly divided into two groups：group A was implanted with X-Stop system,group B was implanted with X-Stop system.We compared the efficacy and lumbar structure changes.Results There was no significant difference in operative time and blood loss between two groups（P〉0.05）,but implantation time of group A was significantly lower than group B（P〈0.05）;After treatment,VAS score and ODI score decreased significantly（P〈0.05）,but there was no statistically significant difference between two groups（P〉0.05）.After surgery,patients＇ Cobb angle,intervertebral foramen diameter,longitudinal diameter/lower vertebral height and the disc height/lower vertebral height increased significantly（P〈0.05）in both groups.And the isc height/lower vertebral height in group A was significantly higher than group B after treatment,（P〈0.05）;L_（4~5） segmental motion ROM value decreased after surgery（P〈0.05）,but group B decreased more significantly（P〈0.05）.There was no significant change in Woodend points before and after surgery in two groups（P〉0.05）,and no statistically significant difference between two groups（P〉0.05）.During 1-year follow-up,patients were satisfied with surgery affect,and had a good recovery,there were no significant complications such as infection,nerve damage,fixation failure or dural sac rupture occured.Conclusion Both of X-Stop system and Wallis system are safe and effective which can effectively restore lumbar lordosis,increase the height of intervertebral space and intervertebral foramen area,but the X-Stop is more effective compared to the Wallis in increasing the height of the intervertebral space.