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经皮腰椎管狭窄减压术与新型棘突间装置。

Percutaneous decompression of lumbar spinal stenosis with a new interspinous device.

机构信息

Department of Diagnostic and Molecular Imaging, Interventional Radiology, Nuclear Medicine and Radiation Therapy, University of Rome Tor Vergata, viale Oxford 81, 00133, Rome, Italy.

出版信息

Cardiovasc Intervent Radiol. 2012 Apr;35(2):368-74. doi: 10.1007/s00270-011-0167-1. Epub 2011 May 28.

Abstract

OBJECTIVE

This study was designed to evaluate the feasibility of the implantation of a new interspinous device (Falena) in patients with lumbar spinal stenosis. The clinical outcomes and imaging results were assessed by orthostatic MR during an up to 6-month follow-up period.

METHODS

Between October 2008 and February 2010, the Falena was implanted at a single level in 26 patients (17 men; mean age, 69 (range, 54-82) years) who were affected by degenerative lumbar spinal stenosis. All of the patients were clinically evaluated before the procedure and at 1 and 3 months. Furthermore, 20 patients have completed a 6-month follow-up. Pain was assessed before and after the intervention using the Visual Analogue Scale score and the Oswestry Disability Index questionnaire. Orthostatic MR imaging was performed before the implantation and at 3 months to assess the correlation with the clinical outcome.

RESULTS

The mean ODI score decreased from 48.9 before the device implantation to 31.2 at 1 month (p < 0.0001). The mean VAS score decreased from 7.6 before to 3.9 (p < 0.0001) at 1 month and 3.6 at 3 months after the procedure (p = 0.0115). These values were stable at 6 months evaluation. No postimplantation major complications were recorded. MRI evaluation documented in most cases an increased size of the spinal canal area. Similarly a bilateral foraminal area improvement was found. The variation of the intervertebral space height measured on the posterior wall was not significant.

CONCLUSIONS

In our preliminary experience with the Falena in a small cohort of patients, we obtained clinical and imaging results aligned to those reported with similar interspinous devices.

摘要

目的

本研究旨在评估在腰椎管狭窄症患者中植入新型棘突间装置(Falena)的可行性。通过长达 6 个月的随访期间的直立 MRI 评估临床结果和影像学结果。

方法

2008 年 10 月至 2010 年 2 月期间,26 名患者(17 名男性;平均年龄 69 岁[范围 54-82 岁])接受了 Falena 单节段植入手术。所有患者在术前和术后 1 个月和 3 个月进行了临床评估。此外,20 名患者完成了 6 个月的随访。在干预前后使用视觉模拟量表评分和 Oswestry 残疾指数问卷评估疼痛。在植入前和 3 个月进行直立 MRI 成像,以评估与临床结果的相关性。

结果

ODI 评分从植入前的 48.9 平均分降至 1 个月时的 31.2(p<0.0001)。VAS 评分从植入前的 7.6 平均分降至 1 个月时的 3.9(p<0.0001)和 3 个月时的 3.6(p=0.0115)。这些值在 6 个月评估时保持稳定。未记录到植入后的重大并发症。MRI 评估在大多数情况下记录了椎管面积的增加。同样,双侧椎间孔面积也得到了改善。在后壁上测量的椎间空间高度的变化不显著。

结论

在我们对一小批患者使用 Falena 的初步经验中,我们获得了与类似棘突间装置报告的临床和影像学结果一致的结果。

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