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时间:2018-09-04
《双节段人工腰椎间盘置换术的疗效与探讨.doc》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、双节段人工腰椎间盘置换术的疗效与探讨作者:廖翔,高志增,黄山虎,杨述华【摘要】[目的]观察采用以双段SBCharitéⅢ人工椎间盘置换术治疗退变性腰椎间盘疾病的临床结果并探讨其可行性。[方法]自2000年10月至2006年8月,对22例L4~S1退变的病例采用双节段人工腰椎间盘置换术,男16例,女6例;年龄43~54岁,平均48岁;均获得随访,随访时间10~61个月(平均37.4个月),分别于手术前后对患者的情况进行JOA评分和影像学对比。[结果]术后病例JOA评分较术前显著提高(P<0.05)。按FRANKLE标准,JOA评分改善率1年后优12例,良7例,可3例;3年后共获
2、得随访18例,其中优10例,良5例,可3例。术后X线片显示人工椎间盘位置正确,椎间隙高度恢复正常,椎间活动度得到维持。15例患者返回原工作,2例变换工作,1例退休。所有病例无假体功能并发症发生,无假体松动、半脱位、下沉。[结论]在严格适应证的前提下,双节段人工椎间盘置换术是可以获得满意临床疗效的,可在有条件的医院积极开展。【关键词】人工椎间盘;置换;假体;腰椎退变Abstract:[Objective]ToinvestigatetheclinicalresultsoftwolevellumbartotaldiscreplacementwithSBCharitéⅢprosth
3、esisatearlymetaphaseanddiscusstheindication.[Method]FromOctober2000toAugust2006,22patientswhosuffereddegenerativediscdiseasefromL4toS1underwenttwolevelartificiallumbardiscreplacementwithSBCharitéⅢprosthesis.Therewere16menand6women.Theaverageageofthepatientatsurgerywas48years(range,43to54yea
4、rs).Thedurationoffollowupevaluationranged24to94months,withanaverageof59.5months.JOAscoreandradiologicaloutcomeswereusedtoaccessthecurativeeffect.[Result]TheaveragepostoperativeJOAscorewasstatisticallysignificantlyhigherthanpreoperativeJOAscore(P<0.05).AccordingtotheFRANKLEevaluation,12pati
5、entshadexcellentimprovementrateofJOA,7hadgoodimprovementand3hadsuboptimalimprovementinIyearfollowup;10patientshadexcellentimpmwment,5hadgoodimprovementand3hadsuboptimalimprovementin3yearfollowup.PlainXrayfilmsconfirmedthatthediscprosthesiswasplacedinaccuratepositionandtheintervertebralheig
6、htandlumbarspinemotionwererestored.Nosubluxatiooandloosenoftheprosthesiswereidentified.Complicationrelatedtothedeviceshadnotoccurred.[Conclusion]TwolevellumbartotaldiscreplacementwithSBCharitéⅢprosthesishaveidealtherapeuticoutcomeatearlymetapbase,butthe6indicationshouldbestricfiylimitedand
7、itslongtermfollowupstillawaitfurtherinvestigation.TwolevelTDRcouldbedevelopedinconditionalhospitals.Keywords:spinaltuberculosis;spinalsupress;debridement;bonegraft;internalfixation人工椎间盘置换术(totaldiscreplacement,TDR)是现代脊柱外科治疗退行性腰椎间盘疾病(degenerativediscdisea
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