Dynesys弹性固定术与传统术式治疗单节段腰椎间盘突出症的临床疗效比较

Comparison of clinical efficacy between Dynesys elastic fixation and traditional surgery for single lumbar disc herniation

目的比较Dynesys弹性固定术与传统术式治疗单节段腰椎间盘突出症的临床疗效。方法回顾性分析2016年11月至2018年11月本院收治的80例单节段腰椎间盘突出症患者的临床资料,根据手术方式不同分为观察组和对照组,各40例。对照组给予单纯核髓切除术治疗,观察组给予Dynesys弹性固定术治疗,比较两组手术时间、术中出血量、住院时间、疼痛程度评分(VAS)评分、功能障碍评分(ODI)、椎间活动度(ROM)、椎间隙高度及炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)]变化。结果两组手术时间、术后住院时间及术中出血量比较差异均无统计学意义;术后3个月及末次随访,观察组VAS、ODI评分低于对照组(P<0.05);观察组ROM小于对照组,椎间隙高度大于对照组(P<0.05);术后24 h,观察组血清CRP、IL-6、IL-10水平均低于对照组(P<0.05)。结论 Dynesys弹性固定术治疗单节段腰椎间盘突出症疗效显著,可缓解疼痛程度,维持椎间隙高度,保留节段运动功能,降低炎性因子水平。

Objective To compare the clinical efficacy of Dynesys elastic fixation with traditional surgical treatment of single-segment lumbar disc herniation.Methods The clinical data of 80 patients with single-segment lumbar disc herniation admitted from November 2016 to November 2018 were retrospectively analyzed.They were divided into observation group and control group,with 40 cases in each group.The control group was treated with pure medulla resection,the observation group was treated with Dynesys flexible fixation,and the operation time,intraoperative blood loss,hospital stay,pain degree score(VAS)score,dysfunction score(ODI),Intervertebral mobility(ROM),intervertebral space height,and inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),interleukin-10(IL-10)]changes were compared between the two groups.Results There was no significant difference in the operation time,postoperative hospital stay,and intraoperative blood loss between the two groups.The VAS and ODI scores in the observation group at 3 months and the last follow-up were lower than those in the control group(P<0.05).The ROM of the observation group was smaller than that of the control group,and the height of the intervertebral space was larger than that of the control group(P<0.05).The serum CRP,IL-6,and IL-10 levels of the observation group were lower than those of the control group at 24 hours after surgery(P<0.05).Conclusion Dynesys elastic fixation is effective in treating single-segment lumbar disc herniation,which can alleviate pain,maintain the height of the intervertebral space,retain segmental motor function,and reduce inflammatory factor levels.