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腰椎退行性疾病患者聚醚醚酮棒的影像学结果:至少5年随访

Radiological outcomes of PEEK rods in patients with lumbar degenerative diseases: A minimum 5-year follow-up.

作者信息

Huang Weimin, Wang Wenqiao, Xu Xiaoduo, Wang Lei, Wang Jingming, Yu Xiuchun

机构信息

Orthopaedic Department, 960 Hospital of People's Liberation Army, Jinan, China.

出版信息

Front Surg. 2023 Mar 27;10:1146893. doi: 10.3389/fsurg.2023.1146893. eCollection 2023.

Abstract

PURPOSE

To determine the long-term radiological outcomes of PEEK rods in patients with lumbar degenerative diseases.

METHODS

Radiological outcomes of cohort cases with lumbar degenerative diseases following PEEK rods were retrospectively studied. Disc height index (DHI) and range of motion (ROM) were measured by x-rays. The CT scans and reconstruction were used to determine screw breakage, rods fracture, screw loosening and intervertebral bony fusion status. The MRI scans were used to evaluate the changes of intervertebral discs at the non-fusion segments and adjacent segments in terms of Pfirrmann Classification.

RESULTS

A total of 40 patients completed the mean of 74.8 ± 9.6 months follow-up, with 32 patients undergoing hybrid surgery and 8 patients undergoing non-fusion surgery. The mean DHI changed from preoperative 0.34 to 0.36 at the final follow-up and the ROM declined from 8.8° preoperatively to 3.2° at the final visit, however, both had no statistical differences. Of the 40 levels underwent non-fusion procedure, 9 levels showed disc rehydration with 7 patients from Grade 4 to Grade 3 and 2 patients from Grade 3 to Grade 2. The other 30 cases did not show distinctive change. No screw loosening or rods breakage were detected during the follow-up periods.

CONCLUSION

PEEK rods have obvious protective effects on degenerated intervertebral disc of non-fusion segments and the incidence of complications related to internal fixation is low. PEEK rods pedicle screw system is safe and effective in the treatment of lumbar degenerative diseases.

摘要

目的

确定聚醚醚酮(PEEK)棒在腰椎退行性疾病患者中的长期放射学结果。

方法

回顾性研究腰椎退行性疾病患者使用PEEK棒后的队列病例放射学结果。通过X线测量椎间盘高度指数(DHI)和活动范围(ROM)。利用CT扫描及重建来确定螺钉断裂、棒材骨折、螺钉松动及椎间骨融合状态。采用MRI扫描根据Pfirrmann分级评估非融合节段及相邻节段椎间盘的变化。

结果

共40例患者完成平均74.8±9.6个月的随访,其中32例行混合手术,8例行非融合手术。末次随访时平均DHI从术前的0.34变为0.36,ROM从术前的8.8°降至末次随访时的3.2°,但两者均无统计学差异。在40个接受非融合手术的节段中,9个节段出现椎间盘再水化,7例从4级变为3级,2例从3级变为2级。其他30例未显示明显变化。随访期间未检测到螺钉松动或棒材断裂。

结论

PEEK棒对非融合节段退变椎间盘有明显保护作用,内固定相关并发症发生率低。PEEK棒椎弓根螺钉系统治疗腰椎退行性疾病安全有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f78f/10083248/e962626fa5a1/fsurg-10-1146893-g001.jpg

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