非融合稳定弹性棒固定系统和髓核摘除椎间融合椎弓根钉棒固定系统治疗腰椎退行性变的效果比较

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Abstract Objective To compare the effect of non-fusion stable elastic rod fixation system and nucleus pulposus removal intervertebral fusion pedicle screw rod fixation system in the treatment of lumbar degeneration.Methods A total of 40 patients with severe lumbar degeneration who required surgery in Fuyong People′s Hospital of Bao′an District in Shenzhen City from December 2016 to June 2018 were selected as the research objects.They were divided into the dynamic fixation group and the fusion fixation group according to the random lottery method, with 20 cases in each group.Patients in the dynamic fixation group were treated with pedicle elastic rod internal fixation system without removing the nucleus pulposus, and patients in the fusion fixation group were routinely treated with nucleus pulposus removal intervertebral fusion pedicle screw rod system internal fixation.The visual analogue scale (VAS) of low back pain, lower extremity pain, the Oswestry dysfunction (ODI) index and overall lumbar spine mobility before and after surgery, and incidence of postoperative complications were compared between the two groups.Results All 40 patients successfully completed the operation and were followed up after the operation.There were no statistically significant differences in the VAS score, ODI index and the overall lumbar spine mobility between the two groups at three days after operation(P＞0.05).At six months after operation, the VAS score and ODI index of the dynamic fixation group were lower than those of the fusion fixation group, the differences were statistically significant (P＜0.05).At 12 and 18 months after surgery, there were no significant differences in the VAS score and ODI index between the two groups (P＞0.05).At 6,12, and 18 months after surgery, the overall lumbar spine mobility of the dynamic fixation group was higher than that of the fusion fixation group, and the difference was statistically significant (P＜0.05).The lumbar spine pain, function and mobility were improved in the two groups at 6, 12, and 18 months after surgery compared with this group at three days after surgery, and the differences were statistically significant (P＜0.05).No serious complications occurred in both groups.Conclusion Both the non-fusion stable elastic rod fixation system and the nucleus pulposus removal intervertebral fusion pedicle screw rod fixation system are effective surgical methods for the treatment of lumbar degeneration,and they can achieve good surgical results.The dynamic fixation group has the advantages of rapid relief of pain, quick recovery of overall postoperative lumbar spine mobility, large postoperative lumbar spine overall mobility, reduced incidence of degeneration of adjacent segments, and rehydration of nucleus pulposus after surgery.But the dynamic fixed group also has stress and deformation of elastic rods.

Key words： Lumbar degeneration Dynamic stabilization Nucleus pulposus regeneration Interbody fusion

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YEJun,WANGHai-tao. Effect comparison of non-fusion stable elastic rod fixation system and nucleus pulposus removal intervertebral fusion pedicle screw rod fixation system in the treatment of lumbar degeneration[J]. 中国当代医药, 2021, 28(8): 13-17.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I8/13

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