活性L全椎间盘置换术有效性的回顾性研究：1至3年随访的临床及影像学结果
Retrospective study on effectiveness of activ L total disc replacement: clinical and radiographical results of 1- to 3-year follow-up.
作者信息
Lu Shibao, Kong Chao, Hai Yong, Wang Qingyi, Zang Lei, Kang Nan, Meng Xianglong, Wang Yu
机构信息
From the Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
出版信息
Spine (Phila Pa 1976). 2015 Apr 1;40(7):E411-7. doi: 10.1097/BRS.0000000000000773.
STUDY DESIGN
Retrospective case series study.
OBJECTIVE
To assess the effectiveness of activ L total disc replacement (TDR) on degenerative disc diseases with the clinical and radiographical results.
SUMMARY OF BACKGROUND DATA
There are few reports on activ L TDR. This is the first one from China.
METHODS
From March 2009 to March 2012, 32 patients with degenerative disc diseases underwent mono- or bisegmental lumbar TDR. Mean age was 45.1 years (32-58 yr). Clinical outcomes were measured by Oswestry Disability Index and Visual analogue scale pre- and postoperatively (1, 2, and 3 yr). Radiographical parameters as range of motion and intervertebral disc height of the index- and adjacent segments were also measured. Prosthesis subsidence and heterotopic ossification were observed during the follow-up period. Work status was also tracked.
RESULTS
Thirty patients were available for a mean follow-up of 28.8 months and had complete radiographical data. At the final follow-up, the success rate was 86.7%. Visual analogue scale score for low back pain and leg pain, and Oswestry Disability Index scores significantly improved after surgery. Average intervertebral disc heights of patients with more than 3 years' follow-up at the index segment and upper and lower adjacent segments were 12.87 mm, 12.61 mm, and 11.62 mm, respectively, showing no significant difference compared with preoperative scores. The range of motion of the index and upper adjacent segments showed a significant increase for patients with more than 3 years' follow-up. Changes of range of motion at lower adjacent segment were not significant. We observed tears of the iliac vein in 2 patients, prosthesis subsidence in 3 patients, and heterotopic ossification in 1 patient. At the final follow-up, 18 patients went back to their original work, 8 patients changed jobs, and 4 patients stopped working.
CONCLUSION
The 1- to 3-year follow-up of this cohort of patients showed satisfactory clinical outcomes. The long-term results of activ L TDR need more investigation.
LEVEL OF EVIDENCE
研究设计
回顾性病例系列研究。
目的
通过临床和影像学结果评估activ L全椎间盘置换术（TDR）治疗椎间盘退变疾病的有效性。
背景资料总结
关于activ L TDR的报道较少。这是来自中国的首例报道。
方法
2009年3月至2012年3月，32例椎间盘退变疾病患者接受了单节段或双节段腰椎TDR。平均年龄45.1岁（32 - 58岁）。通过术前及术后（1年、2年和3年）的Oswestry功能障碍指数和视觉模拟评分来评估临床结果。还测量了目标节段及相邻节段的活动度和椎间盘高度等影像学参数。在随访期间观察假体下沉和异位骨化情况。同时追踪工作状态。
结果
30例患者可进行平均28.8个月的随访并拥有完整的影像学数据。末次随访时，成功率为86.7%。术后下腰痛和腿痛的视觉模拟评分以及Oswestry功能障碍指数评分均显著改善。随访超过3年的患者目标节段及其上、下相邻节段的平均椎间盘高度分别为12.87mm、12.61mm和11.62mm，与术前评分相比无显著差异。随访超过3年的患者目标节段及上相邻节段的活动度显著增加。下相邻节段活动度变化不显著。我们观察到2例患者出现髂静脉撕裂，3例患者出现假体下沉，1例患者出现异位骨化。末次随访时，18例患者恢复原工作，8例患者更换工作，4例患者停止工作。
结论
对该队列患者1至3年的随访显示临床结果令人满意。activ L TDR的长期结果需要更多研究。
证据级别
2级
Zotero 插件