Bioflex动态稳定系统在多节段腰椎退行性疾病中的应用

目的：探讨Bioflex动态稳定系统在多节段腰椎退行性疾病中的应用价值。方法：回顾性分析2008年4月至2009年5月收治的多节段腰椎退行性疾病患者13例,男8例,女5例;年龄51～72岁,平均65.0岁。病变节段：L3,4、L4,5、L5S17例,L2,3、L3,4、L4,5、L5S13例,L3,4、L4,51例,L4,5、L5S12例。手术方法：椎管减压、Bioflex系统固定、根据椎间盘退变程度选择椎体间融合或不融合。观察疼痛视觉模拟评分（visual analog scale,VAS）,Oswestry功能障碍指数（Oswestry disability index,ODI）,节段活动范围（rangeofmotion,ROM）,椎间融合节段的融合情况。结果：术后经12～26个月随访,平均19.5个月。手术时间90～240min,平均183.4min,术中出血量400～1220ml,平均610.2ml。术前VAS为（7.8±1.3）分,术后为（2.3±0.9）分,末次随访为（2.1±0.8）分;术前ODI为（60.50±4.40）%,术后为（17.80±2.10）%,末次随访为（16.20±2.40）%。与术前比较,术后VAS、ODI差异均具有统计学意义（P〈0.05）,术后与末次随访结果无明显差异（P〉0.05）。手术前后ROM：整个腰椎和非融合节段活动度明显减低,邻近节段略增加。融合节段融合率95.0%（19/20）。结论：Bioflex系统固定结合椎体间融合是治疗多节段腰椎退行性疾病的一种安全、有效的外科方法,远期效果待进一步观察。

Application of Bioflex dynamic stabilization system in treating multi-segment lumbar degenerative disease

Objective: To explore the value of application of Bioflex dynamic stabilization system in treating multi-segment lumbar degenerative disease. Methods: Clinical datas of 13 patients with multi-segment lumbar degenerative disease(8 males and 5 females, ranging in age from 51 to 72 year with an average of 65.0) were retrospectively analyzed between April 2008 and May 2009. The involved area included L₃-S₁ in 7 cases, L₂-S₁ in 3 cases, L₃-L₅ in 1 cases, L₄-S₁ in 2 cases. All patients underwent decompression, dynamic stabilization with Bioflex system, according to the severity of degenerative disc with/without interbody fusion. The clinical effects were evaluated by VAS, ODI. ROM and fusion segments were also observed. Results: The mean follow up period was 19.5 months(from 12 to 26 months). The mean operative time was 183.4 min (from 90 to 240 min) and the mean volume of blood loss was 610.2 ml(from 400 to 1 220 ml). The mean VAS score was 7.8±1.3 preoperatively, 2.3±0.9 postoperatively and 2.1±0.8 at the last follow up. The average ODI was(60.50±4.40)% preoperatively, (17.80±2.10)% postoperatively and (16.20±2.40)% at the last follow up.The VAS and ODI significant improved in postoperatively(P<0.05), and there was no statistical difference between postoperative and last follow up (P>0.05). ROM of whole lumbar and non-fused segment showed obviously decreased and adjacent segment showed insignificant increased. The fusion rate of interbody fusion level was 95.0%(19/20). Conclusion: The preliminary clinical results show the Bioflex system combined with intebody fusion is a safe and effective technique in treating multi-segment lumbar degenerative disease.