PEEK棒半刚性固定与钛棒刚性固定治疗腰椎管狭窄症的效果及创伤程度比较

Comparison of efficacy and trauma degree between PEEK rod semi-rigid fixation and titanium rod rigid fixation in the treatment of lumbar spinal stenosis

目的比较PEEK棒半刚性固定与钛棒刚性固定治疗腰椎管狭窄症的效果及创伤程度。方法前瞻性选择2018年8月至2019年8月在保定市第二中心医院接受内固定手术治疗的90例腰椎管狭窄症患者,采用随机数字表法将其分为接受PEEK棒半刚性固定的PEEK组45例、接受钛棒刚性固定的对照组45例。比较2组患者的手术情况、血清创伤指标[肌红蛋白(MYO)、乳酸脱氢酶(LDH)、皮质醇(COR)]、影像学测量指标、功能评分。结果PEEK组的手术时间与对照组比较,差异无统计学意义(P>0.05),手术切口长度、术中出血量及术后引流量明显低于对照组(P<0.05);手术后3 d时,2组患者的血清MYO、LDH、COR含量均明显升高,且PEEK组的血清MYO、LDH、COR含量均明显低于对照组(P<0.05);手术后6个月及12个月时,PEEK组的Cobb角、椎体前缘高度丢失率、JOA评分与对照组比较,差异无统计学意义(P>0.05),ROM明显高于对照组、ODI评分明显低于对照组(P<0.05)。结论PEEK棒半刚性固定治疗腰椎管狭窄症能够减小创伤程度,改善腰椎功能,且解剖固定效果与钛棒刚性固定相当。

Objective To compare the efficacy and traumatic degree of PEEK rod semi-rigid fixation and titanium rod rigid fixation in the treatment of lumbar spinal stenosis.Methods Ninty patients with lumbar spinal stenosis underwent internal fixation in Baoding Second Central Hospital from August 2018 to August 2019 were perspectively selected and divided into PEEK group 45 cases treated with semi-rigid PEEK rod fixation and control group 45 cases treated with rigid titanium rod fixation according to the random number table method.The operation condition,serum trauma index[myoglobin(MYO),lactate dehydrogenase(LDH),cortisol(COR)],imaging measurement index and functional score were compared between the two groups.Results There was no significant difference in operation time between PEEK group and control group(P>0.05).The incision length,bleeding volume and drainage volume of PEEK group were significantly lower than those of control group(P<0.05).At 3 days after operation,the serum MYO,LDH and COR levels of two groups significantly increased(P<0.05),and the serum MYO,LDH and COR levels in PEEK group were significantly lower than those in control group(P<0.05).At 6 months and 12 months after operation,there was no significant difference in Cobb angle,loss rate of anterior vertebral height and JOA score between PEEK group and control group(P>0.05),ROM was significantly higher than that of control group,ODI score was significantly lower than that of control group(P<0.05).Conclusion PEEK rod semi-rigid fixation for lumbar spinal stenosis can reduce the degree of trauma and improve the function of lumbar spine,and the effect of anatomical fixation is similar to that of titanium rod rigid fixation.