椎弓根固定系统在腰椎退行性疾病治疗中的应用

Application of pedicle fixation system in treatment of lumbar degenerative conditions

目的研究椎弓根固定器械在腰椎退行性疾病的应用指征、疗效和安全性。方法对121例应用椎弓根器械进行治疗的腰椎退行性疾病的患者进行随访。随访时间0.5～6.1年,平均3.1年。应用Suk标准进行影像学融合情况评估;VAS进行疼痛评估;以Oswestry功能丢失指数进行临床疗效评价。结果VAS(0～10分)评分:术前9.5～6.8(平均8.5),术后0～5.3(平均4.1);Oswestry:术前30～80(平均64),术后0～72(平均38.5)。融合率:91.74%;临床有效率:87.60%。结论椎弓根器械在腰椎退行性疾病的手术治疗中具有提高融合率,促进症状改善,缩短康复时间的作用。同时应关注椎弓根器械的性能-价格比,严格掌握临床应用指征。

Objective To study the indication, effectiveness and safety of pedicle fixation system in the treatment of lumbar degenerative conditions. M ethods 121 cases of lumbar degenerative condition treated with pedicle fixation system were followed up. The mean follow-up period was 3.1 years (0.5 to 6.1yea rs). The radiological fusion situation was evaluated with Suk’s method, the pai n improvement with VAS (visual analog scale), and the clinical results with Oswe stry disability index. Results VAS was improved from an average preoperative sco re of 8.5 (9.5 to 6.8) to an average postoperative one of 4.1(0.1 to 5.3); Oswes try disability index was improved from an average preoperative score of 64 (30 t o 80) to an average postoperative one of 38.5 (0 to 72). And the fusion rate was 91.74%; the clinical efficiency was 87.60%. Conclusions Pedicle fixation sys tem is considered effective in improving fusion rate, relieving symptoms and sho rtening recovery time. We should also concern about the cost-effectiveness valu e, and strictly follow the clinical application indication.