减压结合Dynesys动态稳定治疗退行性腰椎管狭窄症

Dynamic stabilization system in addition to decompression for the degenerative spinal stenosis

[目的]探讨减压结合Dynesys动态稳定系统治疗退行性腰椎管狭窄症的疗效和安全性。[方法]2007年1月～2008年6月,对23例退行性腰椎管狭窄症患者在后路减压后行Dynesys内固定术。[结果]随访(26.2±7.3)个月(17～34)个月,VAS评分:术前(8.2±0.9)分(6～10分),术后(2.2±1.3)分(0～5分)(P=0.001);Oswestry评分:术前(72.4±17.0)分(45～89分),术后(22.4±14.7)分(0～43分)(P=0.002)。无椎弓根螺钉松动、断裂。按中华医学会骨科学分会脊柱学组腰背痛手术评定标准评价:优17例,良4例,可2例,症状改善优良率达91.3%。[结论]减压结合Dynesys治疗退行性腰椎管狭窄症可取得良好的早期临床效果,防止固定及邻近节段的退变,是治疗腰椎退行性疾病的一种有效的非融合性、动力性固定方法。

[Objective]To investigate the efficacy and safety of the dynamic stabilization system in addition to decompression for degenerative lumbar spinal stenosis. [Methods]From January 2007 to June 2008,23 patients with consecutive lumbar spinal stenosis underwent decompression and Dynesys dynamic stabilization .[Results]The follow-up period were （26.2±7.3） months （range 17-34 months）. The VAS decreased from preoperative score of （8.2±0.9）（6-10） to postoperative score of（ 2.2±1.3） （0 to 5） （P=0.001）,and the patients’ Oswestry disability index was improved from preoperative score of （72.4±17.0）（45 to 89）to postoperative score of （22.4±14.7）（0 to 48）（P=0.002）. No patient had screw loosensing and screw breakage. According to clinical outcome judgement criterion of surgical treatment for low back pain formulated by the spine group of Chinese Orthopaedic Association,there were excellent results in 17cases,good 4 cases,fair 2 cases,the excellent to good rate was 91.3%.[Conclusion]Early outcome were excellent with the Dynesys dynamic stabilization system decompression for degenerative lumbar spinal stenosis. It could prevent the degeneration of the instrumented level and the adjacent segments. It is a nonfusion and semirigid fixation for the lumbar degenerative diseases.