使用动态杆系统和刚性杆系统治疗腰椎退行性疾病的腰椎后部稳定效果比较。

Alp Karaaslan, Necat Biber, Burak Özdemir, Kadir Altaş, Ercan Kaya, Ece Sağlam Çifci, Recep Başaran
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摘要

研究目的本研究旨在评估动态杆系统(PLSDR)和刚性杆系统(PLSRR)在治疗腰椎退行性疾病(LDD)时的临床和放射学效果:对2018年至2023年间在我院接受后路后路稳定手术的98例患者进行回顾性研究。根据植入物的类型将患者分为两组:结果:在对比研究中,第 1 组的椎间盘病变率更高(49% 对 24.5%,P = 0.012)。手术级别存在差异,值得注意的是,只有第一组进行了五级手术(8.2%,P = 0.033)。Pfirrmann 椎间盘退变等级差异显著(p < 0.001),第 2 组主要为 I 级(77.6% 对第 1 组的 36.7%)。第一组的狭窄率(57.1% 对 28.6%,P = 0.004)和面肥厚率(71.4% 对 47%,P = 0.014)更高。第一组的邻近节段变性(ASD)发生率也更高(81.6% 对 51%,P = 0.001)。两组患者的邻近节段退变主要发生在近端(P = 0.202)。两组均无压迫性骨折。随访时间相似(p = 0.183):结论:在治疗 LDD 时,PLSDR 与 PLSRR 相比显示出潜在的优势,包括保留相邻节段的退变。
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Comparison posterior lumbar stabilization with dynamic rod system and rigid rod system for lumbar degenerative disease.

Objective: This research aims to assess the clinical and radiological outcomes of both dynamic rod system (PLSDR) and rigid rod system (PLSRR) when treating lumbar degenerative disease (LDD).

Method: A retrospective review of 98 patients who underwent posterior stabilization surgery with a posterior approach in our clinic between 2018 and 2023 was conducted. The patients were divided into two groups based on the type of implant used: Those with PLSRR (Group 1) and those with PLSDR (Group 2).

Results: In a comparative study, Group 1 had a higher prevalence of discopathy (49% vs. 24.5%, p = 0.012). Differences in surgical operation levels existed, and notably, only Group 1 had five-level surgeries (8.2%, p = 0.033). Pfirrmann disk degeneration grades differed significantly (p < 0.001), with Group 2 mainly in Grade I (77.6% vs. 36.7% in Group 1). Stenosis (57.1% vs. 28.6%, p = 0.004) and facet hypertrophy (71.4% vs. 47%, p = 0.014) were higher in Group 1. Group 1 also showed a greater adjacent segment degeneration (ASD) incidence (81.6% vs. 51%, p = 0.001). Both groups had primarily proximal ASD degeneration (p = 0.202). Compression fractures were absent. Follow-up durations were similar (p = 0.183).

Conclusions: In treating LDD, the PLSDR shows potential advantages over PLSRR, including preservation of degeneration in adjacent segments.

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