[1]黄伟敏,于秀淳,梁进,等.PEEK棒椎弓根螺钉系统治疗老年腰椎退行性疾病的疗效分析[J].中华老年骨科与康复电子杂志,2016,(04):211-216.[doi:10.3877/cma.j.issn.2096-0263.2016.04.004]
　Huang Weimin,Yu Xiuchun,et al.Clinical outcome of PEEK rod pedicle screw system for senile lumbar degenerative disease[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(04):211-216.[doi:10.3877/cma.j.issn.2096-0263.2016.04.004]
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PEEK棒椎弓根螺钉系统治疗老年腰椎退行性疾病的疗效分析()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2016年04期
页码:
211-216
栏目:
脊柱专题
出版日期:
2016-11-05

文章信息/Info

Title:
Clinical outcome of PEEK rod pedicle screw system for senile lumbar degenerative disease
作者:
黄伟敏 1; 2; 于秀淳 2; 梁进 2; 宋若先 2; 周珂 2; 韩志伟 2
200433 上海，第二军医大学研究生院 1；250031 济南军区总医院骨病科 2
Author(s):
Huang Weimin1;  2;  Yu Xiuchun2;  Liang Jin2;  Song Ruoxian2;  Zhou Ke2;  Han Zhiwei2
1Department of Graduate School, Second Military Medical University, Shanghai 200433, China; 2Department of Orthopedics, General Hospital of Jinan Military Commanding Region, Jinan 250031, China
关键词:
腰椎;  内固定器;  脊柱融合术;  老年人
Keywords:
Lumbar vertebrae;  Internal fixators;  Spinal fusion;  senile
DOI:
10.3877/cma.j.issn.2096-0263.2016.04.004
文献标志码:
A
摘要:
目的 观察聚醚醚酮树脂（PEEK）棒椎弓根螺钉内固定系统治疗老年腰椎退行性疾病的可行性和有效性。方法 前瞻性收集 2013年 7月至 2014年 3月济南军区总医院符合纳入排除标准的老年腰椎退行性疾病患者 41 例，根据两组患者术中采用椎弓根螺钉材质的不同，将其随机分为 PEEK棒组（n=21）和钛棒组（n=20）。术前所有患者行 X线腰椎正侧位、过伸过屈位、CT、MRI检查，随访并观察术前、术后 3个月、6个月及 1年的欧氏功能障碍指数（ODI）、日本骨科学会评分（JOA）、螺钉松动、断裂及假关节形成情况，术后 1年行 CT平扫加三维重建，评估内固定及融合情况。结果 41例患者均获得成功随访，随访时间为 10～15个月，平均(12.7±1.4)个月。两组患者手术前后各时间点的 ODI及 JOA评分组间比较差异均无统计学意义。PEEK棒组患者末次随访时的 ODI评分由术前（46.8±8.3）分降至（15.9±3.1）分，钛棒组患者末次随访时的 ODI评分由术前（45.2±7.4）分降至（16.6±3.5）分，差异均具有统计学意义（F=14.235，F=12.361，P＜0.05），PEEK棒组JOA评分由术前（12.2±2.6）分提高至（22.4±3.9）分，钛棒组 JOA评分由术前（12.8±2.4）分提高至（22.3±3.6）分，差异均具有统计学意义（F=20.186，F=17.015， P＜0.05）。PEEK 棒组所有患者未出现螺钉松动断裂及 PEEK 棒断裂情况，钛棒组有 2 例患者出现螺钉松动。PEEK棒组患者（12/15）椎间骨性融合率与钛棒组（15/20）无统计学差异（c2=9.012，P=0.527）。结论 PEEK棒椎弓根螺钉内固定系统术后可明显改善老年腰椎退行性疾病患者的临床症状，疗效较为满意。
Abstract:
Objective To evaluate the feasibility and validity of polyetheretherketone (PEEK) rod pedicle screw internal fixation system for senile lumbar degenerative disease (LDD). Methods A perspective study was performed in 41 senile LDD from July 2013 to March 2014. They were divided into PEEK group (n=21) and titanium rod group (n=20) randomly according to different materials of pedicle screw in each group. All patients got front and lateral, hyperextension and hyperflexion X- ray films, CT scan, MRI before surgery. The oswestry dysfunctional index (ODI), Japanese orthopedics association (JOA), pseudarthrosis, screw loosening and rupture at 3 months, 6 months and 12 months were followed-up after surgery. 12 months after surgery, a three- dimensional CT reconstructions were achieved to observe the integrity of PEEK rods. Results All 41 patients received an average 12.7±1.4 months follow-up (range, 10-15 m) . There was no statistically significant difference of ODI and JOA between two groups before and after operation. At the last follow-up visit, the ODI score decreased to 15.9±3.1 from preoperative 46.8±8.3 in PEEK group, the ODI score decreased to 16.6±3.5 from preoperative 45.2±7.4 in titanium rod group with statistical significance (F=14.235, F=12.361, P<0.05), the JOA score increased to 22.4±3.9 from preoperative 12.2±2.6 in PEEK group, the JOA score increased to 22.3±3.6 from preoperative 12.8±2.4 in titanium rod group with statistical significance (F=20.186, F=17.015, P<0.05). No screw loosening, screw and rods breakage occurred in PEEK group, while 2 cases in titanium rod group showed screw loosening. There was no statistically significant difference (c2=9.012, P=0.527) of fusion rate between PEEK group (12/15) and titanium rod group (15/20). Conclusion PEEK rod pedicle screw internal fixation system can improve clinical symptom obviously and achieve excellent functional outcomes in elderly LDD.

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备注/Memo

备注/Memo:
基金项目：院长基金专项基金（201201z1）
更新日期/Last Update: 2017-04-01