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椎间盘切除术对腰椎退行性疾病 Dynysys 动力固定的影响。

Effect of Discectomy on Dynesys Dynamic Fixation in the Treatment of Lumbar Degenerative Diseases.

机构信息

Department of Orthopedics, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Pain Res Manag. 2021 Dec 30;2021:3043645. doi: 10.1155/2021/3043645. eCollection 2021.

Abstract

OBJECTIVE

To compare the effect of decompression of the spinal canal with or without discectomy on the clinical efficacy of Dynesys dynamic fixation treatment in lumbar degenerative diseases.

METHODS

A total of 62 patients treated for single-segment lumbar degenerative disease from October 2010 to November 2017 were retrospectively analyzed. All patients underwent decompression of the spinal canal with Dynesys dynamic fixation and were divided into two groups. Twenty-seven patients in group A did not undergo discectomy, and 35 patients in group B underwent discectomy. The intervertebral height, range of motion, Pfirrmann grade of the surgical segment and the upper adjacent segment, function scores, and operation information were compared.

RESULTS

All patients were followed up for an average of 30.7 ± 11.5 months. At the final follow-up, the intervertebral height and range of motion of the surgical segment decreased significantly in both group A and B ( < 0.05), the range of motion of the upper adjacent segment increased significantly ( < 0.05), and the intervertebral height did not change significantly ( < 0.05). The retained percentages of surgical segment intervertebral height and ROM in group A were significantly better than those in group B ( < 0.05). The intervertebral height ( > 0.05) and range of motion ( < 0.05) of the surgical segment in group A were higher than those in group B. The surgical segment Pfirrmann grading of group A was better than that of group B ( < 0.05).

CONCLUSION

Dynesys in the treatment of lumbar degenerative diseases may lead to a good clinical effect. In selected cases without discectomy, the range of motion and intervertebral height may be better preserved, and disc degeneration may be reduced.

摘要

目的

比较单纯椎管减压与减压联合椎间盘切除治疗腰椎退变性疾病中 Dynysys 动力固定的临床疗效。

方法

回顾性分析 2010 年 10 月至 2017 年 11 月收治的单节段腰椎退变性疾病患者 62 例,均行 Dynysys 动力固定椎管减压治疗,分为两组。A 组 27 例未行椎间盘切除,B 组 35 例行椎间盘切除。比较两组患者的椎间高度、活动度、手术节段及上位邻近节段的 Pfirrmann 分级、功能评分及手术相关信息。

结果

所有患者均获平均 30.7±11.5 个月随访。末次随访时,A、B 两组手术节段的椎间高度和活动度均显著降低(<0.05),上位邻近节段活动度显著增加(<0.05),而椎间高度无明显变化(<0.05)。A 组手术节段椎间高度和 ROM 的保留率明显优于 B 组(<0.05)。A 组手术节段的椎间高度(>0.05)和活动度(<0.05)均高于 B 组,手术节段的 Pfirrmann 分级优于 B 组(<0.05)。

结论

Dynysys 治疗腰椎退变性疾病可能具有良好的临床疗效,在选择合适病例行单纯减压术时,可能更好地保留活动度和椎间高度,减少椎间盘退变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/daf1/8736702/0a65aeb9f793/PRM2021-3043645.001.jpg

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