聚醚醚酮棒半刚性固定系统在腰椎融合术中的应用

Clinical Application of Polyetheretherketone Rod Semi-rigid Fixation System in Lumbar Fusion

目的:比较聚醚醚酮(PEEK)棒半刚性固定系统和钛棒刚性固定系统在腰椎融合术中的临床疗效。方法:回顾性分析2015年6月至2018年6月行后路椎间植骨融合术(PLIF)治疗腰椎退变性疾病患者54例,按照内固定材料分为两组(PEEK棒组27例,钛棒组27例)。其中男18例,女36例;年龄52~72岁,平均(54.6±4.3)岁。所有患者术前均行腰椎正侧位X线片、腰椎过伸过屈X线片、CT平扫、腰椎MRI检查。通过比较两组患者术前及术后3,6,12个月Oswestry功能障碍指数(ODI)和日本骨科学会(JOA)评分评价临床疗效。术后3,6,12个月通过Brantigan椎间融合标准评价植骨融合情况。结果:54例患者术后均得到随访,随访时间12~24个月,平均(16.4±4.2)个月。所有患者均未出现伤口感染、脑脊液漏、内固定松动及断裂等并发症。术后3,6,12个月两组患者ODI均呈下降趋势,两组间差异无统计学意义(P>0.05);术后3,6,12个月两组患者JOA评分均呈上升趋势,两组间差异无统计学意义(P>0.05)。术后3个月PEEK棒组融合率高于钛棒组,两组间差异有统计学意义(P<0.05);术后6个月两组患者融合率均为100%,两组间差异无统计学意义(P>0.05)。结论:PEEK棒半刚性固定系统与钛棒内固定系统在腰椎融合术中均可取得良好临床疗效,但PPEK棒半刚性固定系统早期融合疗效更佳。

Objective:To compare the clinical efficacy of polyetheretherketone(PEEK)rod semi-rigid fixation system and titanium rod rigid fixation system in lumbar fusion.Methods:A retrospective analysis was performed on 54 patients who underwent posterior lumbar interbody fusion(PLIF)for the treatment of lumbar degeneration from June 2015 to June2018 in our department.According to the internal fixation materials,the patients were divided into two groups:27 patients in the PEEK rod group and 27 patients in the titanium rod group.There were 18 males and 36 females.The average age was 52~72 years old(54.6±4.3).All patients were received positive and lateral lumbar X-ray,lumbar hyperextension and hyperflexion X-ray,plain CT scan,and lumbar MRI before surgery.Oswestry dysfunction index(ODI)and Japanese Orthopedic Association(JOA)scores at 3,6 and 12 months before and after surgery were compared between the two groups to evaluate the clinical efficacy.The bone graft fusion was evaluated by Brantigan intervertebral fusion criteria at 3,6 and 12 months postoperatively.Results:All the 54 patients were followed up after surgery from 12 to 24 months,an average of(16.4±4.2)months.None of the patient had complications such as surgical incision infection,cerebrospinal fluid leakage,loosing or breaking internal fixation,and others complications.Oswestry dysfunction index of the two groups decreased at 3,6 and 12 months after surgery,and the difference between the two groups was not statistically significant(P>0.05).Postoperative JOA scores of patients in the two groups showed an increasing trend at 3,6 and 12 months after surgery,and the difference between the two groups was not statistically significant(P>0.05).3 months after surgery,the fusion rate of PEEK stick group was higher than that of titanium stick group,and the difference between the two groups was statistically significant(P<0.05).6 months after surgery,the fusion rate of the two groups was 100%,and there was no significant difference between the two groups(P>0.05).Conclusion:PEEK semi-rigid fixation system and titanium rod internal fixation system can achieve equal clinical efficacy in lumbar fusion.But the PEEK rods semi-rigid fixation system early fusion curative effect is better.