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首页> 外文期刊>BMC Musculoskeletal Disorders >Interspinous process stabilization with Rocker via unilateral approach versus X-Stop via bilateral approach for lumbar spinal stenosis: a comparative study
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Interspinous process stabilization with Rocker via unilateral approach versus X-Stop via bilateral approach for lumbar spinal stenosis: a comparative study

机译：腰椎管狭窄症的单侧入路Rocker对比双侧入路X-Stop稳定棘突

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Background Rocker is a novel interspinous process stabilization (IPS) that can be installed via unilateral approach by virtue of its unique design. This controlled study compared the clinical outcome of Rocker versus X-Stop to access the feasibility and validity of the novel IPS. Methods From March 2011 to September 2012, 32 patients treated with Rocker and 30 patients treated with X-Stop were enrolled in this study. The primary clinical outcome measure was Oswestry Disability Index (ODI) score. The secondary clinical outcome measure was Japanese orthopaedics association (JOA) score. Disc height index (DHI) and foraminal height index (FHI) were measured for postoperative radiographic evaluation. Implant failures were also recorded. Results There were 55 patients with complete data during 24?months follow-up. Among the 55 patients, 38 patients underwent IPS in combination with microdecompression. At the final follow-up, 49 patients achieved a minimal clinical important difference (≥8 points ODI improvement). The mean operative time was 53.6?min (range, 30 to 90?min) in Rocker group and 63.1?min (range, 30 to 100?min) in X-Stop group. The average blood loss was 111?ml (range, 50 to 400?ml) in Rocker group and 138?ml (range, 50 to 350?ml) in X-Stop group. ODI score were significantly improved from preoperative 46.8?±?9.2 to 12.2?±?2.6 at 24?months follow-up in the Rocker group and from preoperative 45.8?±?9.8 to 11.8?±?2.4 at 24?months follow-up in the X-Stop group. JOA score also improved significantly in both groups. The radiographic parameters of DHI and FHI in both groups increased immediately postoperatively, however, the improvements seemed to revert toward initial value during follow-up. Two patients in Rocker group demonstrated implant dislocation within one week postoperatively and one patient in X-Stop group demonstrated implant migration at two months postoperatively. Conclusions Preliminary clinical and radiographic outcome was similar between Rocker and X-Stop group. For patients of lumbar spinal stenosis with unilateral nerve root involved or mild-to-moderate central canal stenosis, Rocker offers a new alternative with less damage.
机译：背景技术Rocker是一种新颖的棘突间稳定术（IPS），凭借其独特的设计可以通过单侧方法进行安装。这项对照研究比较了Rocker和X-Stop的临床结果，以了解新型IPS的可行性和有效性。方法自2011年3月至2012年9月，本研究纳入32位接受Rocker治疗的患者和30位接受X-Stop治疗的患者。主要的临床结局指标为Oswestry残疾指数（ODI）评分。次要临床结局指标是日本骨科协会（JOA）评分。测量椎间盘高度指数（DHI）和椎间孔高度指数（FHI），以进行术后放射线照相评估。还记录了植入失败。结果在24个月的随访中，有55例具有完整数据的患者。在55例患者中，有38例接受了IPS联合微减压治疗。在最后的随访中，有49名患者的临床重要差异最小（ODI改善≥8分）。 Rocker组平均手术时间为53.6？min（范围为30至90？min），X-Stop组平均手术时间为63.1？min（范围为30至100？min）。在Rocker组中，平均失血量为111μml（范围为50至400μml），在X-Stop组中，平均失血量为138μml（范围为50至350μml）。在Rocker组中，ODI评分在术前24个月时从术前的46.8±±9.2明显提高到12.2±±2.6，在术后24个月时从术前的45.8±±9.8改善到11.8±±2.4。在X-Stop组中。两组的JOA评分也显着提高。两组DHI和FHI的放射学参数在术后立即增加，但是在随访期间，这些改善似乎恢复到了初始值。 Rocker组中的2例患者在术后1周内出现了种植体脱位，X-Stop组中的1例患者在术后2个月内出现了种植体迁移。结论Rocker和X-Stop组的初步临床和影像学结果相似。对于患有单侧神经根受累或轻度至中度中央管狭窄的腰椎管狭窄症患者，Rocker提供了一种损伤较小的新选择。

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