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跳过后路动力性经椎弓根稳定术治疗远节段退变疾病

Skipping posterior dynamic transpedicular stabilization for distant segment degenerative disease.

作者信息

Solmaz Bilgehan, Aydin Ahmet Levent, Gomleksiz Cengiz, Ataker Yaprak, Sasani Mehdi, Oktenoglu Tunc, Ozer Ali Fahir

机构信息

Neurosurgery Department, Medistate Hospital, Istanbul, Turkey.

出版信息

Adv Orthop. 2012;2012:496817. doi: 10.1155/2012/496817. Epub 2012 Oct 3.

Abstract

Objective. To date, there is still no consensus on the treatment of spinal degenerative disease. Current surgical techniques to manage painful spinal disorders are imperfect. In this paper, we aimed to evaluate the prospective results of posterior transpedicular dynamic stabilization, a novel surgical approach that skips the segments that do not produce pain. This technique has been proven biomechanically and radiologically in spinal degenerative diseases. Methods. A prospective study of 18 patients averaging 54.94 years of age with distant spinal segment degenerative disease. Indications consisted of degenerative disc disease (57%), herniated nucleus pulposus (50%), spinal stenosis (14.28%), degenerative spondylolisthesis (14.28%), and foraminal stenosis (7.1%). The Oswestry Low-Back Pain Disability Questionnaire and visual analog scale (VAS) for pain were recorded preoperatively and at the third and twelfth postoperative months. Results. Both the Oswestry and VAS scores showed significant improvement postoperatively (P < 0.05). We observed complications in one patient who had spinal epidural hematoma. Conclusion. We recommend skipping posterior transpedicular dynamic stabilization for surgical treatment of distant segment spinal degenerative disease.

摘要

目的。迄今为止,对于脊柱退行性疾病的治疗仍未达成共识。当前用于治疗疼痛性脊柱疾病的手术技术并不完善。在本文中,我们旨在评估后路经椎弓根动态稳定术的前瞻性结果,这是一种跳过不产生疼痛节段的新型手术方法。该技术在脊柱退行性疾病中已得到生物力学和放射学验证。方法。对18例平均年龄54.94岁的远节段脊柱退行性疾病患者进行前瞻性研究。适应症包括椎间盘退变(57%)、髓核突出(50%)、椎管狭窄(14.28%)、退行性椎体滑脱(14.28%)和椎间孔狭窄(7.1%)。术前以及术后第三个月和第十二个月记录Oswestry下腰痛残疾问卷和疼痛视觉模拟量表(VAS)。结果。Oswestry和VAS评分术后均有显著改善(P < 0.05)。我们观察到1例患者出现了硬脊膜外血肿并发症。结论。我们建议对于远节段脊柱退行性疾病的手术治疗不采用后路经椎弓根动态稳定术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b638/3471421/e2b74ea73624/AOP2012-496817.001.jpg

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