PEEK棒系统的杂合术式治疗腰椎退变性疾病

Hybrid procedure with PEEK rod stabilization system for treatment of lumbar degenerative diseases

[目的]探讨PEEK(polyetheretherketone,PEEK)棒系统的杂合术式治疗腰椎退变性疾病的临床疗效。[方法]回顾性分析本院2015年3月~2017年6月收治并符合纳入标准的腰椎退变性疾病患者20例的临床资料。男8例,女12例;年龄55~83岁,平均(68.20±6.87)岁;病变节段为L3~S1。采用PEEK棒内固系统进行融合与非融合结合的杂合术式进行治疗。采用疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评价症状改善情况,Stauffer-Coventry标准进行临床疗效评价。测量手术固定节段近端临近椎间隙高度(DSH)、活动范围(ROM)。[结果]20例患者均顺利完成手术,1例术中硬膜撕裂予以缝合,未发生不良后果,手术切口均Ⅰ期愈合。随访时间12~39个月,平均(18.55±4.66)个月。术后6个月及末次随访时,VAS、ODI评分均较术前明显改善(P<0.001)。末次随访时,根据Stauffer-Coventry评价标准,临床疗效评价优15例,良3例,中2例,优良率为90%。术后无内固定断裂、松动及神经功能损伤等相关并发症发生。术后6个月及末次随访时邻近节段DSH、ROM与术前比较,差异均无统计学意义(P>0.05)。[结论]PEEK棒内固定系统联合应用杂合术式治疗腰椎退变性疾病,临床早期疗效满意。

[Objective] To explore clinical outcome of hybrid procedure with PEEK (polyetheretherketone) rod dynamic stabilization system in treatment of lumbar degenerative diseases.[Methods] A retrospective study was conducted on 20 patients who underwent hybrid stabilization with PEEK rod for lumbar degenerative diseases in our hospital from March 2014 to June 2017. Of them, 8 males and 12 females aged 55~83 years with an average age of (68.20±6.87) years had pathology involved from L3 to S1. The hybrid procedures consisted of the pathologized segment fusion, and the adjacent segments non-fusion with a PEEK rod dynamic stabilization system. The VAS, ODI and Stauffer-Coventry criteria were used for evaluation of clinical consequences, additionally the disc space height (DSH) and range of motion (ROM) on dynamic lateral views of X rays were measured.[Results] All the patients had surgical procedures performed smoothly, and only one patient got dural tear in operation, which was repaired without serious consequence. The incision in all of them achieved primary healing without infection. The follow-up period lasted for 12~39 months with an average of (18.55±4.66) months. The VAS and ODI scores significantly decreased at 6 months postoperatively and the latest follow up compared with those preoperatively (P<0.05). Based on the Stauffer-Coventry criteria, the clinical outcome was graded as excellent in 15, good in 3 and fair in 2 patients, with a excellentgood rate of 90%. In term of radiographic assessment, both the DSH and ROM of the upper adjacent segment kept no significant changes at the latest follow up compared with those preoperatively (P>0.05). No loosening or breaking of the internal implants happened in anyone of the 20 patients to the latest follow up.[Conclusion] This hybrid procedure with PEEK rod dynamic stabilization system does achieve satisfactory early clinical outcomes for lumbar degenerative diseases.