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[等压动态稳定系统固定联合腰椎间盘切除术治疗腰椎间盘突出症患者的短期疗效]

[Short-term effect of Isobar dynamic stabilization system fixation combined with lumbar discectomy in patients with lumbar disc herniation].

作者信息

Liu Y L, Yang H, Zhang M, Ruan T C, Li P F, Xiong Y J, Wang L M, Wang Y Q

机构信息

Department of Orthopedics, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2019 Jan 15;99(3):188-192. doi: 10.3760/cma.j.issn.0376-2491.2019.03.007.

Abstract

To investigate the short-term effect of Isobar dynamic stabilization system fixation combined with lumbar discectomy in patients with lumbar disc herniation. From June 2015 to June 2017, 62 patients with lumbar disc herniation treated in the First Affiliated Hospital of Zhengzhou University were divided into control group and observation group according to the therapy. The 31 patients in the control group were treated with simple excision of nucleus pulposus and the 31 patients in the observation group were treated with Isobar dynamic stabilization system fixation combined with lumbar discectomy. The score of Oswestry disability index (ODI) and Japanese Orthopedic Association (JOA) score of low back pain, lumbar and adjacent stage activity, inflammatory factor levels[C reaction protein (CRP), interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α)] were compared between the two groups before and after the operation and 6 months after the operation. The data were compared between the two groups with test. After the operation and 6 months after, the ODI scores of the two groups decreased and the JOA scores increased significantly (25.5±3.0, 27.5±3.2 vs 15.3±2.2 and 18.6±2.3, 23.3±2.9 vs 15.3±2.0), the ODI scores of the observation group was significantly lower than those in the control group; the JOA scores were significantly higher than those in the control group (0.04-10.19, all 0.05). The operative time, hospital stay, intraoperative blood lose and complications rate in the observation group were all significantly lower than those in the control group. The total activity of lumbar vertebrae in the observation group was significantly higher than that in the control group after operation and 6 months after (37.67, 36.60, both 0.05); the activity of adjacent segments in the observation group was significantly lower than that of the control group (9.28, 3.79, both 0.05); the Pfirrmann grade was significantly lower than that in the control group (3.11, 5.05, both 0.05). The levels of CRP, IL-6 and TNF-α in the two groups were lower than those before operation, and those were also significantly lower in the observation than the corresponding indexes in the control group (0.52-10.99, all 0.05). Isobar dynamic stable system fixation combined with lumbar intervertebral disc resection can effectively improve the lumbar function and lumbar activity in patients with lumbar intervertebral disc herniation, and reduce the level of inflammation and relapse.

摘要

探讨等压动态稳定系统固定联合腰椎间盘切除术治疗腰椎间盘突出症患者的短期疗效。选取2015年6月至2017年6月在郑州大学第一附属医院接受治疗的62例腰椎间盘突出症患者,根据治疗方法分为对照组和观察组。对照组31例患者采用单纯髓核摘除术治疗,观察组31例患者采用等压动态稳定系统固定联合腰椎间盘切除术治疗。比较两组患者手术前、手术后及术后6个月的Oswestry功能障碍指数(ODI)评分、日本骨科协会(JOA)下腰痛评分、腰椎及相邻节段活动度、炎症因子水平[C反应蛋白(CRP)、白细胞介素6(IL-6)和肿瘤坏死因子α(TNF-α)]。两组数据采用检验进行比较。术后及术后6个月,两组ODI评分均降低,JOA评分均显著升高(25.5±3.0、27.5±3.2 对比 15.3±2.2、18.6±2.3,23.3±2.9 对比 15.3±2.0),观察组ODI评分显著低于对照组;JOA评分显著高于对照组(0.04 - 10.19,均P<0.05)。观察组手术时间、住院时间、术中出血量及并发症发生率均显著低于对照组。观察组术后及术后6个月腰椎总活动度显著高于对照组(37.67、36.60,均P<0.05);观察组相邻节段活动度显著低于对照组(9.28、3.79,均P<0.05);Pfirrmann分级显著低于对照组(3.11、5.05,均P<0.05)。两组CRP、IL-6和TNF-α水平均低于手术前,且观察组上述指标均显著低于对照组(0.52 - 10.99,均P<0.05)。等压动态稳定系统固定联合腰椎间盘切除术可有效改善腰椎间盘突出症患者的腰椎功能和腰椎活动度,降低炎症水平及复发率。

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