新型PEEK棒半刚性固定系统应用于腰椎退变性疾病手术治疗的临床疗效

The clinical outcomes of a novel PEEK rod semi-rigid fixation system in the treatment of lumbar degenerative disease

中文关键词:  腰椎  退变性疾病  PEEK棒  钛棒  椎间融合

英文关键词:Lumbar vertebrae  Degenerative disease  PEEK rod  Titanium rod  Interbody fusion.

中文摘要:

  【摘要】 目的：观察聚醚醚酮（polyetheretherketone，PEEK）棒半刚性固定系统应用于腰椎退变性疾病后路减压、椎体间融合手术治疗的临床效果。方法：回顾性分析2010年1月～2012年1月收治的51例行后路椎间植骨融合术（PLIF）的腰椎退变性疾病患者，PEEK棒内固定组24例，钛合金棒固定组27例；均行标准腰椎后路减压、椎间融合、内固定术。通过腰痛VAS评分及下肢痛VAS评分、ODI评分等指标评价临床疗效；采用改良Brantigan椎间融合标准评价植骨融合情况。结果：所有患者均获得完整的术后随访资料。两组术后不同时间点腰痛及下肢痛VAS评分、ODI评分较术前比较差异有统计学意义（P<0.01）；末次随访时，PEEK棒组患者腰痛VAS评分（1.9±0.4）明显优于钛棒组（2.1±0.4），差异有统计学意义（P<0.05），两组间下肢痛VAS评分及ODI评分差异无显著性（P>0.05）。根据改良Brantigan椎间融合标准，术后3个月PEEK棒组（83.3%，20例）融合率显著高于钛棒组（55.6%，15例），两组间差异有显著性（P<0.05）；术后6个月，PEEK棒组融合率为91.7%，而钛棒组融合率为81.5%（22例），两组间差异无显著性（P>0.05）；术后12个月两组植骨融合率差异无显著性（P>0.05）。结论：PEEK棒-椎弓根螺钉半刚性内固定系统应用于腰椎退变性疾病临床治疗中可获得满意的临床疗效，与传统钛棒内固定系统比较术后腰痛持续缓解明显，其长期疗效仍需要进一步观察。

英文摘要:

  【Abstract】 Objectives: To evaluate the clinical outcomes of polyetheretherketone(PEEK) rod semi-rigid fixation system in the treatment of lumbar degenerative disease. Methods: From January 2010 to January 2012, 51 cases with lumbar degenerative disease were randomized into two groups: PEEK rod group(24 cases) and titanium alloy rod group(27 cases). The posterior lumbar interbody fusion with pedicle screw fixation was performed on all patients. The VAS scores of back pain and leg pain, and the ODI scores of leg pain were evaluated. The spine fusion was assessed according to the modified Brantigan grade. Results: All patients were followed up. Compared with the preoperation, significant differences were detected in the VAS scores and ODI scores of back pain and leg pain at the differrent postoperative time points between two groups (P<0.01). The VAS scores of back pain(1.9±0.4) in the PEEK rod group were lower than those of the control group (2.1±0.4)(P<0.05). At the latest follow-up, no significant difference was detected between two groups on leg pain VAS score and ODI score. According to the modified Brantigan grade, at 3 months after operation, the fusion rate in the PEEK rod group(83.3%, 20 cases) was higher than that in the titanium rod group(55.6%, 15 cases)(P<0.05). At 6 months after operation, the fusion rate in the PEEK rod group(91.7%, 22 cases) was still higher than that in the control group(81.5%, 22 cases)(P>0.05). At 12 months after operation, there was no significant difference in fusion rate between two groups(P>0.05). Conclusions: The semi-rigid lumbar fixation system(PEEK rod) can achieved satisfied clinical outcomes in the treatment of lumbar degenerative disease. Compared with traditional titanium rod fixation system, it has lower back pain. But the long-term outcomes need to be further studied.