Wallis动态稳定系统治疗腰椎退行性疾病

Preliminary observation of Wallis dynamic stabilization system for treatment of lumbar degenerative diseases

目的分析Wallis棘突间动态稳定系统治疗腰椎退行性疾病的早期效果,并探讨其手术适应证。方法分析26例单独采用Wallis棘突间动态稳定系统或联合固定融合术治疗腰椎退行性疾病患者的临床疗效和初期随访结果,记录术前及术后疼痛视觉模拟量表(visual analogue scale,VAS)评分(10分法)、下腰痛日本骨科协会(JapaneseOrthopaedic Association,JOA)评分(29分法),计算JOA改善率评估手术疗效。结果经6～24个月(平均14个月)的随访,影像学显示内置物无松动、移位或断裂。术前1 d、术后2周及末次随访时VAS评分分别为7.62±1.50、2.42±1.03、0.85±0.73,下腰痛JOA评分分别为10.12±2.42、20.62±2.28、24.92±2.45。末次随访JOA改善率达到优良的为24例(92.3%)。结论 Wallis棘突间动态稳定系统或联合固定融合术治疗腰椎退行性疾病保留了手术节段脊柱有益运动功能,损伤小,初期随访疗效优良,可作为治疗腰椎退行性疾病的新选择。

Objective To analyze the early clinical effects of Wallis dynamic stabilization system for the treatment of lumbar degenerative diseases,and to discuss the indications of this technique.Methods The clinical outcomes of 26 patients with lumbar degenerative diseases treated by only Wallis interspinous dynamic stabilization system or combined with posterior lumbar fusion were studied retrospectively.The visual analogue scale（VAS） and Japanese Orthopaedic Association（JOA） scores were recorded pre-and postoperatively.The ratio of JOA was applied to evaluate the curative effect.Results All the cases were followed up for a mean period of 14months（ranged 6-24 months）.Imaging showed all implants no loosening,dislocation or fracture.The VAS scores were 7.62 ± 1.50,2.42 ± 1.03,0.85 ± 0.73 at 1 d preoperative,2 weeks postoperative and the final follow-up respectively.JOA scores were 10.12 ± 2.42,20.62 ± 2.28,24.92 ± 2.45 at 1 d preoperative,2 weeks postoperative and the final follow-up respectively.The JOA improvement rates of 24 cases（92.3%） were good/excellent at the final follow-up.Conclusion It is benefit to use Wallis interspinous dynamic stabilization system or combination with posterior lumbar fusion for remaining motor function of reserved spinal segments,with the advantage of mini-tissue damage and excellent effects.It is a good choice for the treatment of lumbar degenerative diseases.