腰椎双侧人工小关节置换治疗腰椎管狭窄症的初步报告

Preliminary application of total facet arthroplasty for lumbar spine stenosis

中文关键词:  腰椎管狭窄症  小关节置换  疗效  早期

英文关键词:Lumbar spine stenosis  Total facet arthroplasty  Clinical efficacy  Early stage

中文摘要:

  【摘要】 目的：探讨腰椎双侧人工小关节置换治疗腰椎管狭窄症的早期安全性和疗效。方法：对6例单节段退变性腰椎管狭窄症患者采用双侧人工腰椎小关节置换术进行治疗。术后随访观察手术节段的运动保留情况，并对腰腿痛和腰椎功能分别进行VAS评分和Oswestry功能障碍指数（ODI）评定。结果：所有患者顺利完成手术。所有患者术后下肢放射痛症状全部消失，腰痛缓解。随访12~15个月，平均14个月，VAS评分自术前平均7.8±1.7分降至术后1年时的1.8±1.5分；ODI自术前（66±11.5）%降至术后1 年时的（18±8.0）%；手术节段前屈后伸角度术前为9.3°±1.8°，术后1年为6.3°±1.2°。随访期间人工关节假体无松动、移位、断裂等并发症发生。结论：腰椎小关节置换可以重建脊柱的稳定，不干扰前方结构，可部分保留节段运动，早期临床效果满意，但远期效果还需要进一步观察。

英文摘要:

  【Abstract】 Objective：To evaluate the safety and efficacy of priliminary application of total facet arthroplasty sysetem（TFAS） for lumbar spine stenosis.Method：6 patients with lumbar spine stenosis irresponsible to conservertive treatment underwent total facet joint arthrpoplasty.The clinic data was collected and segmental movement were evaluated by postoperative radiorgaphy.VAS and Oswestry disability index（ODI） were recorded before surgery and at 1m，3m，6m，1y and final follow up respectively.Result：All operations were performed successfully.6 cases complaining of back pain and leg pain had symptoms relieved completely after operation.All patients were followed up from 12m to 15m（mean，14m）.The mean VAS decreased from 7.8±1.7 score pre-operatively to 1.8±1.5 score at 1 year follow-up.The mean ODI decreased from （66±11.5）% pre-operatively to （18±8.0）% at 1 year follow-up.All patients had the intervetebral disc height well maintained and segmental motion partially preserved.No case had prosthesis related neurological deficits at 1 year follow-up.Conclusion：TFAS aims to restore normal lumbar spine alignment and motion preservation，its preliminary application and early outcomes are prospective and encouraging, however further clinical researches are still needed.