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腰椎退变性疾病应用 Isobar TTL 半刚性棒系统治疗的两年随访结果。

Two-year follow-up results of the Isobar TTL Semi-Rigid Rod System for the treatment of lumbar degenerative disease.

机构信息

Department of Orthopaedic Surgery, The 210 Hospital of the People's Liberation Army, Dalian, Liaoning Province, China.

出版信息

J Clin Neurosci. 2013 Mar;20(3):394-9. doi: 10.1016/j.jocn.2012.02.043. Epub 2012 Dec 20.

Abstract

We retrospectively assessed the indications, safety and efficacy of a new dynamic stabilization system (the Isobar TTL Semi-Rigid Rod System, Scient'x, Bretonneux, France) for the treatment of lumbar degenerative disease in 37 consecutive patients (M:F=16:21, mean age 40.2 years) with lumbar degenerative disease who underwent surgery between June 2006 and May 2009. One patient was lost to follow-up. Clinical outcomes were evaluated using the Oswestry Disability Index (ODI) and the Visual Analogue Scale (VAS); range-of-motion (ROM) and disc height index (DHI) were assessed with radiography. Patients were followed for a mean of 24 months (range: 12-36 months). At the 3-month follow-up, there was significant improvement in VAS and ODI (p<0.05); at long-term follow-up VAS showed additional significant improvement (p<0.05) and ODI remained stable. At short-term follow-up, DHI was significantly restored (p<0.05) and ROM declined slightly (but not significantly); however, at long-term follow-up DHI was significantly reduced (p<0.05) compared to short-term follow-up and ROM was significantly decreased compared to the preoperative values (p<0.05). There were new signs of degeneration at adjacent levels in 14 patients (39%) on long-term follow-up MRI. Revision was required in three patients (8%) 24 months after the first operation due to adjacent segment disease. Screw loosening was observed in four patients (11%). The Isobar System after microsurgical decompression for lumbar degenerative disease provided excellent improvement in leg and back pain and patient satisfaction at late follow-up; however, evidence to suggest that Isobar outperforms traditional fusion is lacking. Larger studies of longer duration are warranted.

摘要

我们回顾性评估了一种新的动态稳定系统(法国 Scient'x 公司的 Isobar TTL 半刚性棒系统)在 37 例连续腰椎退行性疾病患者(男女比 16:21,平均年龄 40.2 岁)中的应用,这些患者于 2006 年 6 月至 2009 年 5 月期间接受了手术治疗。1 例患者失访。临床结果采用 Oswestry 功能障碍指数(ODI)和视觉模拟评分(VAS)进行评估;采用影像学评估活动范围(ROM)和椎间盘高度指数(DHI)。患者平均随访 24 个月(12-36 个月)。在 3 个月的随访时,VAS 和 ODI 有显著改善(p<0.05);在长期随访时,VAS 进一步显著改善(p<0.05),ODI 保持稳定。在短期随访时,DHI 显著恢复(p<0.05),ROM 略有下降(但无统计学意义);然而,在长期随访时,与短期随访相比,DHI 显著降低(p<0.05),与术前相比,ROM 显著降低(p<0.05)。在长期随访的 MRI 上,14 例患者(39%)出现了相邻节段的新退变征象。首次手术后 24 个月,因相邻节段病变,有 3 例患者(8%)需要再次手术。4 例患者(11%)出现螺钉松动。对于腰椎退行性疾病,在显微镜下减压后,Isobar 系统在晚期随访时提供了极佳的腿痛和腰痛改善,患者满意度高;然而,缺乏证据表明 Isobar 优于传统融合。需要进行更大规模、更长时间的研究。

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