腰椎动态稳定系统Wallis治疗腰椎退行性疾病疗效分析

Effect evaluation of Wallis dynamic stabilization system in surgical treatment of lumbar degenerative disease

目的：探讨Wallis棘突间动态稳定系统治疗腰椎退行性疾病的初期效果。方法：选择我院自2009年1月至2010年3月收治的腰椎失稳症患者21例,失稳节段均行后路棘突间椎管减压、Wallis置入固定治疗,观察治疗前后疼痛视觉模拟法VAS评分、下腰痛JOA评分、Oswestry功能障碍指数变化;失稳节段和相邻节段的活动范围及L4/5节段椎间盘后高度的变化。结果：21例患者均获得随访,随访时间6~18个月,平均10.2个月。手术时间平均78 min（50~105 min）,术中平均出血量250 mL（50~600 mL）。腰痛均消失,术后患者的症状和体征均有明显改善。治疗后VAS评分较术前显著降低（P〈0.05）,JOA评分较术前显著增加（P〈0.05）,ODI评分较术前显著降低（P〈0.05）。术后L4/5节段的活动范围与术前相比明显减少（P〈0.05）,而术后相邻节段L3/4、L5/S1的活动范围与术前相比差异无统计学意义（P〉0.05）。结论：Wallis动态稳定系统置入治疗腰椎失稳症能够取得比较满意的临床效果,可推广使用。

Objective：To investigate the efficiency of Wallis dynamic stabilization system in the treatment of lumbar degenerative disease.Methods：Twenty-one patients suffering from lumbar instability were selected;all unstable segments in these patients were treated with decompression,posterior implantation of Wallis dynamic stabilization system.Visual analogue scale（VAS） and Japanese Orthopedic Association（JOA） scores for low back pain and Oswestry disability index（ODI） were used to evaluate clinical outcomes.In addition,the range of motion（ROM） at the instrumented segment,adjacent segments as well as posterior disc height（PDH） in standing and extension position at L4/5 segment were also measured.Results：Mean duration of 10.2 month′ follow-up ranging from 6-18 months was conducted on all the patients.The mean operation duration was 78 minutes（50-105 minutes）,with bleeding volume of 250 mL（50-600 mL）.Sings and symptoms in all patients were improved significantly after operation.The postoperative VAS was dramatically decreased comparing with that preoperation（P 0.05）;the JOA score was obviously increased（P 0.05）,while ODI score was decreased（P0.05）.The postoperative range of motion for L4/5 segment decreased significantly（P0.05）,while no obvious difference for L3/4,L5/S1 was observed（P0.05）.Conclusions：Good clinical results can be achieved by surgical intervention with Wallis dynamic stabilization system in treating lumbar vertebrae instability.